Question

What is the cutoff for surgery in an abdominal aortic aneurysm in asymptomatic patients?

• A. 5.5 cm
• B. 6.5 cm
• C. 7.5 cm
• D. 8.5 cm

Hint:

Elective repair when an asymptomatic AAA exceeds 5.5 cm, or if symptomatic / rapidly expanding.

Answer 1

The Correct Option is A

Step 1: Frame the decision as a balance between rupture risk (which climbs with diameter) and the procedural risk of elective repair. The threshold is the size at which rupture risk begins to dominate.
Step 2: Large trials established this crossover point at $5.5$ cm for an asymptomatic infrarenal AAA. Below it, surveillance ultrasound is preferred; at or above it, elective open or endovascular repair is offered.
Step 3: Two size-independent triggers also mandate repair: a symptomatic aneurysm (pain, tenderness) and rapid expansion. These override the diameter rule.
Step 4: Choosing 6.5, 7.5, or 8.5 cm would mean watching the aorta into a high-rupture zone, which is unsafe. The accepted operative cutoff is therefore 5.5 cm.
\[\boxed{5.5\ \text{cm}}\]