Should the size threshold for elective abdominal aortic aneurysm repair be lowered in the endovascular era? No.
According to the current international guidelines, patients with infrarenal or juxtarenal abdominal aortic aneurysms (AAAs) measuring > or = 5.5 cm should undergo repair to reduce the risk of rupture. The 5.5-cm-diameter threshold is the size when the AAA rupture rate balances the mortality rates of elective open surgical AAA repair (3%). Endovascular AAA repair (EVAR) is associated with lower perioperative mortality and complication rates compared with open surgical repair. This debate addresses the issue whether the current size threshold for elective AAA repair needs to be lowered in the endovascular era. This article supports the position that the size threshold for AAA repair should not be lowered.
Avgerinos
Efthimios D
ED
Department of Vascular Surgery, Attikon University Hospital, Athens, Greece. efavgerinos@gmail.com
Katsargyris
Athanasios
A
Klonaris
Christos
C
Papapetrou
Anastasios
A
Moulakakis
Konstantinos
K
Liapis
Christos D
CD
D001012:Aorta, Abdominal / Q000473:pathology; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001019:Aortic Rupture / Q000517:prevention & control; D019917:Blood Vessel Prosthesis Implantation; D004108:Dilatation, Pathologic; D017558:Elective Surgical Procedures / Q000592:standards*; D006770:Hospitals, Group Practice; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D016896:Treatment Outcome