Abstract:Abdominal aortic aneurysm is a potentially fatal vascular disease commonly encountered in the elderly population. Although endovascular aneurysm repair (EVAR) has become the preferred treatment modality, the incidence of postoperative endoleaks remains high (20%-40%), with more than 30% of cases requiring secondary interventions, thereby significantly compromising long-term outcomes. To standardize the application of fibrin sealant aneurysm sac filling during EVAR, the Vascular Surgery Professional Committee of the Chinese Association of Rehabilitation Medicine convened a multidisciplinary expert panel. In accordance with the RIGHT reporting guideline and the GRADE evidence grading system, and through two rounds of Delphi surveys to prioritize clinical questions combined with systematic evidence review, the committee developed the Expert consensus on fibrin sealant aneurysm sac filling during endovascular abdominal aortic aneurysmal repair. This consensus systematically addresses key aspects including indications and contraindications, technical procedures, dosage estimation, intraoperative assessment criteria, prevention and management of complications, and postoperative follow-up. It defines criteria for complete sac filling and provides tailored application strategies under various anatomical conditions. The aim of this consensus is to standardize clinical practice, reduce the incidence of endoleaks, improve long-term outcomes after EVAR, and provide vascular surgeons with evidence-informed and practically applicable guidance.