Key result
This debate article supports the position that the current 5.5-cm-diameter size threshold for elective abdominal aortic aneurysm repair should not be lowered in the endovascular era.
Why the study?
Should the size threshold for elective abdominal aortic aneurysm repair be lowered in the endovascular era?
Should the size threshold for elective abdominal aortic aneurysm repair be lowered in the endovascular era?
Despite the lower perioperative mortality of EVAR compared to open repair, the size threshold for elective AAA repair should remain at ≥ 5.5 cm.
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.
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Avgerinos et al. (2010) conducted an editorial in Infrarenal or juxtarenal abdominal aortic aneurysms (AAAs). Lowering the size threshold for elective AAA repair vs. Current 5.5-cm-diameter threshold was evaluated. This debate article supports the position that the current 5.5-cm-diameter size threshold for elective abdominal aortic aneurysm repair should not be lowered in the endovascular era.
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