According to the 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
article supports the position that the size threshold for AAA repair
should not be lowered
