Should the Size Threshold for Elective Abdominal Aortic Aneurysm Repair be Lowered in the Endovascular Era? Yes

Author:

Paraskevas Kosmas I.1,Mikhailidis Dimitri P.2,Andrikopoulos Vassilios3,Bessias Nikolaos3,Bell Sir Peter R. F.4

Affiliation:

1. Department of Vascular Surgery, Red Cross Hospital, Athens, Greece,

2. Department of Clinical Biochemistry (Vascular Disease Prevention Clinic), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), UK

3. Department of Vascular Surgery, Red Cross Hospital, Athens, Greece

4. University of Leicester, UK

Abstract

According to current international guidelines, patients with infrarenal or juxtarenal abdominal aortic aneurysms (AAAs) measuring ≥ 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 paper supports the position that the size threshold for AAA repair should be lowered in the endovascular era.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine

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