The monitoring frequency may depend on aneurysm size and growth rate.

Patients having an aorta anatomically unsuited for EVAR.

Patients being unsuited for open surgery due to comorbidities.

Female patients being operated at a smaller aneurysm diameter than male patients.

Life expectancy was a contributing factor in surgical decision-making.

waiting lists at the radiological units

radiological report turnaround time

waiting lists for additional tests such as heart and lung exams.

Delays due to accessibility to the EVAR service: the local surgeon had to refer eligible candidates to the vascular surgery service at the university hospital. Delays in the subsequent patient trajectory depended on the latter's process time.

Delays due to lack of professional capacity—for example, when EVAR-skilled personnel were on vacation.

Patient in need of EVAR suitability assessment within a few days to complete the decision on whether to operate.

Non-planned, extra workload in information processing due to patients preferring to have their CT exam/tests at private institutes.

Patients seeking to coordinate their own healthcare—for example, when a patient rescheduled his CT exam to take place on the same day as the clinical consultation. As a consequence, the patient was not informed about the surgeon's decision before 2–3 days later (the surgeon had to see the CT result).

Patient not showing up at the scheduled appointment.

Health personnel failing to act: eg, (1) a CT exam–performed at outside units–was not routed to EVAR suitability assessment in timely advance of the clinical consultation; (2) one patient was not enrolled in the surveillance programme at the time of the discovery of aneurysm.