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Treatment
6.5.5.3. Threshold for AAA Repair
COR LOE
Recommendations
1 A 1. In patients with unruptured AAA, repair is recommended in
those with a maximal aneurysm diameter of ≥5.5 cm in men
or ≥5.0 cm in women.
1 B-NR 2. In patients with unruptured AAA who have symptoms that
are attributable to the aneurysm, repair is recommended to
reduce the risk of rupture.
2b C-LD 3. In patients with unruptured saccular AAA, intervention to
reduce the risk of rupture may be reasonable.
2b C-LD 4. In patients with unruptured AAA and aneurysm growth of
≥0.5 cm in 6 months, repair to reduce the risk of rupture may
be reasonable.
6.5.5.4. Open Versus Endovascular Repair of AAA
COR LOE
Recommendations
1 A 1. In patients with nonruptured AAA with low to moderate
operative risk and who have anatomy suitable for either open
or EVAR, a shared decision-making process weighing the risks
and benefits of each approach is recommended.
1 B-NR 2. In patients undergoing elective endovascular repair for
nonruptured AAA, adherence to manufacturer's instructions
for use is recommended.
2a B-NR 3. In patients with nonruptured AAA and a high perioperative
risk, EVAR is reasonable to reduce the risk of 30-day
morbidity, mortality, or both.
2a B-NR 4. For patients with nonruptured AAA, a moderate to high
perioperative risk, and anatomy suitable for an FDA-approved
fenestrated endovascular device, endovascular repair is
reasonable over open repair to reduce the risk of perioperative
complications.
