Lay summary
An abdominal aortic aneurysm is when the main blood vessel in the tummy weakens and expands, which is life-threatening if it ruptures (bursts). Surgery is often recommended when the risk of rupture is greater than the risk of surgery, but we don’t know the best timing for surgery in women. This is because women have mostly been left out of previous research. Women with aneurysms are at a higher risk of rupture, heart attacks, and strokes compared to men. This research asks whether women might benefit from having surgery earlier. The study aims to improve heart and brain health for women with aneurysms by focusing on smoking cessation, healthier diets, and better medications. It will then compare the benefits of early keyhole surgery to the current standard treatment. The research will reduce strokes, heart attacks, and aneurysm ruptures, and will provide better guidelines for doctors treating women with aneurysms.