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Treatment
6.4.3.1 Surveillance of Thoracic Aortic Dilation and
Aneurysm
COR LOE
Recommendations
1 C-LD 1. In patients with a dilated thoracic aorta, a TTE is
recommended at the time of diagnosis to assess aortic valve
anatomy, aortic valve function, and thoracic aortic diameters
2a C-LD 2. In patients with a dilated thoracic aorta, a CT or MRI at
the time of diagnosis is reasonable to assess thoracic aortic
anatomy and diameters.
2a C-LD 3. In patients with a dilated thoracic aorta, follow-up imaging
(with TTE, CT, or MRI, as appropriate based on individual
anatomy) in 6 to 12 months is reasonable to determine the
rate of aortic enlargement; if stable, surveillance imaging every
6 to 24 months (depending on aortic diameter) is reasonable.
6.4.3.2. Surveillance of Abdominal Aortic Dilation and
Aneurysm
COR LOE
Recommendations
1 B-NR 1. In patients with an AAA of 3.0 cm to 3.9 cm, surveillance
ultrasound is recommended every 3 years to assess for interval
change.
1 B-NR 2. In men with an AAA of 4.0 cm to 4.9 cm and in women
with an AAA of 4.0 cm to 4.4 cm, surveillance ultrasound is
recommended annually to assess for interval change.
1 B-NR 3. In men with an AAA of ≥5.0 cm and women with an AAA
of ≥4.5 cm, surveillance ultrasound is recommended every 6
months to assess for interval change.
1 C-EO 4. In patients with an AAA that is inadequately defined with
ultrasound, surveillance CT is recommended.
2a C-LD In such patients, when there is a contraindication to CT or to
lower cumulative radiation risk, surveillance MRI is reasonable.
1 C-EO 5. In patients with an AAA that meets criteria for repair, CT is
recommended for preoperative planning.
