Which Patients Can Be Treated Medically, and Who Needs Surgical Intervention?

Ruptured abdominal aortic aneurysm (AAA) is associated with nearly 100% mortality when left untreated. If a patient presents with an AAA rupture, emergent surgery is required. Patients with symptoms from an unruptured AAA require urgent surgery. Patients with an AAA > 5.5 cm, peripheral artery disease, peripheral arterial aneurysm, or rapid expansion of AAA should undergo elective repair. Surgical options include open repair and endovascular repair. Patients who do not meet criteria for repair should receive counseling on risk factor modification, including tobacco cessation, exercise, blood pressure and cholesterol management, and antiplatelet therapy.