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Elective abdominal aortic aneurysm (AAA) repair

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Surgical treatment of an abdominal aortic aneurysm (AAA) is associated with increased risk of mortality. The 30-day mortality risk in open repair is between 4% and 5% while in endovascular repair this figure is between 1% and 2% (1).

Repairing unruptured aneurysms - when to consider repair (2)


Consider aneurysm repair for people with an unruptured abdominal aortic aneurysm (AAA), if it is:

  • symptomatic
  • asymptomatic, larger than 4.0 cm and has grown by more than 1 cm in 1 year (measured inner-to-inner maximum anterior-posterior aortic diameter on ultrasound)
  • asymptomatic and 5.5 cm or larger (measured inner-to-inner maximum anterior-posterior aortic diameter on ultrasound)

Open surgical repair, standard endovascular aneurysm repair or conservative management

  • open surgical repair should be offered for people with unruptured AAAs meeting the criteria * unless it is contraindicated because of their abdominal copathology, anaesthetic risks, and/or medical comorbidities
  • consider endovascular aneurysm repair (EVAR) for people with unruptured AAAs who meet the criteria * and who have abdominal copathology, such as a hostile abdomen, horseshoe kidney or a stoma, or other considerations, specific to and discussed with the person, that may make EVAR the preferred option
  • consider EVAR or conservative management for people with unruptured AAAs meeting the criteria * who have anaesthetic risks and/or medical comorbidities that would contraindicate open surgical repair

* Consider aneurysm repair for people with an unruptured abdominal aortic aneurysm (AAA), if it is:

  • symptomatic
  • asymptomatic, larger than 4.0 cm and has grown by more than 1 cm in 1 year (measured inner-to-inner maximum anterior-posterior aortic diameter on ultrasound)
  • asymptomatic and 5.5 cm or larger (measured inner-to-inner maximum anterior-posterior aortic diameter on ultrasound)

Reference:


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