When should an abdominal aortic aneurysm (AAA) of 5.5 cm or greater be repaired?

The recommendation to repair an abdominal aortic aneurysm (AAA) measuring 5.5 cm or greater is based on the increased risk of rupture associated with larger aneurysms. Studies have shown that aneurysms of this size carry a significant risk of life-threatening complications, regardless of whether the patient shows symptoms.

An AAA of 5.5 cm or greater represents a critical threshold for intervention because the likelihood of rupture increases dramatically, and waiting for the aneurysm to become symptomatic or to reach a larger size further heightens the risk of a catastrophic event. A repair at this size is typically performed electively to prevent rupture, which could lead to severe morbidity or mortality.

In general, the management guidelines suggest that a repair is warranted for aneurysms of this size even if the patient is asymptomatic. This proactive approach aims to ensure patient safety and improve outcomes, making this rationale the cornerstone of the decision to proceed with repair for aneurysms at this measurement threshold.