title: Is surgery necessary for abdominal aortic aneurysm less than 6 cm in diameter?
abstract: During 8 years of an ultrasound screening programme for abdominal aortic aneurysm (AAA), 8944 people aged 65-80 years were scanned. 356 (4%) had AAA of diameter 3 cm or greater. Under our criteria repair was indicated if the aortic diameter reached 6 cm, if expansion reached 1 cm per year, or if the AAA caused symptoms; 124 patients met these criteria. Among the 8820 screened patients who did not meet the criteria, 1 death (0.4%) was attributed to ruptured aneurysm, although the retroperitoneal haematoma had developed within 5 days of surgery for a colon tumour. The risk of aortic rupture in patients with AAA less than 6 cm diameter with these criteria (0.4%) is lower than that for elective surgery (1-8%). Surgical repair is unnecessary and possibly detrimental in such patients, provided that ultrasound surveillance is undertaken.
authors.affiliation: Scott Research Unit, St Richard's Hospital, Chichester, West Sussex, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Scott
authors.forename: N M
authors.initials: NM
authors.lastname: Wilson
authors.forename: H A
authors.initials: HA
authors.lastname: Ashton
authors.forename: D N
authors.initials: DN
authors.lastname: Kay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D014463:Ultrasonography