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Are We Over Treating Abdominal Aortic Aneurysms?

  • Timothy A. Resch
    Correspondence
    Corresponding author. Copenhagen Aortic Centre, Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark.
    Affiliations
    Copenhagen Aortic Centre, Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark
    Department of Clinical Medicine, Faculty of health and medical Sciences, University of Copenhagen, Denmark
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  • Jonas Eiberg
    Affiliations
    Copenhagen Aortic Centre, Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark
    Department of Clinical Medicine, Faculty of health and medical Sciences, University of Copenhagen, Denmark
    Copenhagen Academy of Medical Education and Simulation (CAMES), Copenhagen, Denmark
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Published:October 07, 2022DOI:https://doi.org/10.1016/j.ejvs.2022.10.009
      Elective abdominal aortic aneurysm (AAA) repair is a prophylactic intervention to prevent AAA rupture. The development of modern surgical treatment of AAA began with the first reports of open aneurysm repair (OAR) with homografts in the early 1950s. Although it was recognised early that AAA diameter was directly correlated with rupture risk (RR), it was not until the 1970s when the first reports came suggesting that an aneurysm diameter above five cm seemed to be the pivot point for this risk. These data were primarily based on small case series and autopsy reports from pioneers, and, in the decades that followed, it remained debated what the optimal size threshold for AAA repair actually was.
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      References

        • Lederle F.A.
        • Wilson S.E.
        • Johnson G.R.
        • Reinke D.B.
        • Littooy F.N.
        • Acher C.W.
        • et al.
        Immediate repair compared with surveillance of small abdominal aortic aneurysms.
        N Engl J Med. 2002; 346: 1437-1444
        • The UK Small Aneurysm Trial participants
        Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms.
        Lancet. 1998; 352: 1649-1655
        • The UK Small Aneurysm Trial participants
        The U.K. Small Aneurysm Trial: design, methods and progress.
        Eur J Vasc Endovasc Surg. 1995; 9: 42-48
        • Manning B.J.
        • Kristmundsson T.
        • Sonesson B.
        • Resch T.
        Abdominal aortic aneurysm diameter: a comparison of ultrasound measurements with those from standard and three-dimensional computed tomography reconstruction.
        J Vasc Surg. 2009; 50: 263-268
        • Wanhainen A.
        • Verzini F.
        • Van Herzeele I.
        • Allaire E.
        • Bown M.
        • Cohnert T.
        • et al.
        Editor’s Choice - European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms.
        Eur J Vasc Endovasc Surg. 2019; 57: 8-93
        • Chaikof E.L.
        • Dalman R.L.
        • Eskandari M.K.
        • Jackson B.M.
        • Lee W.A.
        • Mansour M.A.
        • et al.
        The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm.
        J Vasc Surg. 2018; 67: 2-77
        • Glimaker H.
        • Holmberg L.
        • Elvin A.
        • Nybacka O.
        • Almgren B.
        • Bjorck C.G.
        • et al.
        Natural history of patients with abdominal aortic aneurysm.
        Eur J Vasc Surg. 1991; 5: 125-130
        • Nevitt M.P.
        • Ballard D.J.
        • Hallett Jr., J.W.
        Prognosis of abdominal aortic aneurysms. A population-based study.
        N Engl J Med. 1989; 321: 1009-1014
        • Darling R.C.
        Ruptured arteriosclerotic abdominal aortic aneurysms. A pathologic and clinical study.
        Am J Surg. 1970; 119: 397-401
        • Parkinson F.
        • Ferguson S.
        • Lewis P.
        • Williams I.M.
        • Twine C.P.
        • South East Wales Vascular N
        Rupture rates of untreated large abdominal aortic aneurysms in patients unfit for elective repair.
        J Vasc Surg. 2015; 61: 1606-1612
        • Lancaster E.M.
        • Gologorsky R.
        • Hull M.M.
        • Okuhn S.
        • Solomon M.D.
        • Avins A.L.
        • et al.
        The natural history of large abdominal aortic aneurysms in patients without timely repair.
        J Vasc Surg. 2022; 75: 109-117
        • Oliver-Williams C.
        • Sweeting M.J.
        • Jacomelli J.
        • Summers L.
        • Stevenson A.
        • Lees T.
        • et al.
        Safety of men with small and medium abdominal aortic aneurysms under surveillance in the NAAASP.
        Circulation. 2019; 139: 1371-1380