Abdominal aortic aneurysm surgical repair is generally recommended at which diameter?

• A. 4 cm
• B. 6 cm
• C. 7 cm
• D. 5 cm

Answer: (D)

Deciding when to repair a problem like an abdominal aortic aneurysm hinges on the balance between rupture risk and the risks of surgery. As the diameter grows, the wall stress increases and the chance of rupture climbs more rapidly. Around five centimeters, the rupture risk becomes clinically meaningful enough to justify elective repair for many patients, because the potential benefit of preventing rupture outweighs the risks of the operation. Below this size, aneurysms tend to be watched with regular imaging and risk-factor management, since their rupture risk is comparatively low. If an aneurysm grows quickly (for example, more than about 0.5 cm in six to twelve months) or if it becomes symptomatic, repair is considered regardless of the current diameter.