Current trends in the management of small abdominal aortic aneurysms.
Over the past decade, there have been revolutionary changes in the diagnosis and treatment of abdominal aortic aneurysms. Minimally invasive endovascular technologies have decreased length of stay and, more importantly, improved at least the early outcomes compared with conventional open surgical therapy. Several large, randomized, prospective trials have re-evaluated the optimal size to treat abdominal aortic aneurysms. The guidelines and conclusions from these studies, the UK Small Aneurysm Trial and The Veterans Affairs Administration aneurysm Detection And Management Trial recommend intervening on aortic aneurysms when they reach 5.5 cm in transverse diameter. However, these studies do not bear direct relevance to contemporary management of aneurysms with endovascular techniques. Clinical trials are currently underway to assess the optimal size for treating abdominal aortic aneurysms with endovascular stent grafts.
The Cleveland Clinic-Lerner School of Medicine, Department of Vascular Surgery, S 40, 9500 Euclid Avenue, Cleveland, OH 44195, USA. saract@ccf.org
Timur P
TP
Sarac
Ozcan
O
Altinel
Kenneth
K
Ouriel