This is a great article for all those interested in vascular surgery! And helps explain why >5.5cm is the cut off point for AAA repair. This landmark study by the UK NHS clearly shows that early surgical intervention for small abdominal aortic aneurysms confers no survival benefit over surveillance. For those between 4 and 5.4cm other patient factors and shared decision making become important. However, in all patients with a AAA, symptoms or aneurysm expansion >1cm per year is a good indication for surgical intervention.

The final 12 year follow up from the UK Small Aneurysm Trial was published in 2007, with the most recent guidelines on AAA treatment from the Society for Vascular Surgery reflecting these findings.

UK Small Aneurysm Trial Participants. Long term outcomes of immediate repair compared with surveillance of small abdominal aneurysms. N Engl J Med. 2002 May 9;346(19):1445-52.

UK Small Aneurysm Trial Participants. Final 12-year follow-up of surgery versus surveillance in the UK Small Aneurysm Trial. Br J Surg. 2007 Jun; 94(6):702-8.