Don’t perform open or endovascular repair in most asymptomatic patients with small abdominal aortic aneurysms (<5cm in women, <5.5cm in men).

Repair of asymptomatic abdominal aortic aneurysms is recommended when the risk of rupture exceeds the risk of repair. Randomized controlled trials have failed to show a survival benefit for open or endovascular repair of most small aneurysms. Repair may be considered with specific growth patterns and aneurysm morphology.

 

Sources:

Cao P, et al. Comparison of surveillance versus aortic endografting for small aneurysm repair (CAESAR): results from a randomised trial. Eur J Vasc Endovasc Surg 2011;41(1):13-25. PMID: 20869890.

Lederle FA, et al. Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med 2002;346:1437-44. PMID: 12000813.

Ouriel K, et al. Endovascular repair compared with surveillance for patients with small abdominal aortic aneurysms. J Vasc Surg 2010;51(5):1081-7. PMID: 20304589.

The UK Small Aneurysm Trial Participants. Mortality results for randomized controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet 1998;352:1649-55. PMID: 9853436.

 

Related Resources:

Patient Pamphlet: Treating Blocked Leg Arteries: When you need a procedure and when you don’t