WHAT IS THE LONG-TERM OUTCOME FOR PATIENTS WITH VERY SMALL ABDOMINAL AORTIC-ANEURYSMS

Objective: To determine the long-term outcome for patients with abdomi nal aortic aneurysms (AAA) less than 4 cm in AP diameter (very small A AA). Design: Population-based screening study. Materials and methods: One hundred and forty-two patients who had AAA less than 4 cm at prese ntation were assessed by ultrasound at intervals of 6-12 months. The r ecords of these patients were reviewed. Results: During the period of follow-up the median annual growth rate for aneurysms while under 3.0 cm was 1 mm, rising to 2 mm when between 3.0 and 3.9 cm, and 3 mm when between 4.0 and 4.9 cm in diameter. Elective aneurysm repair was unde rtaken when aneurysms exceeded the threshold value, which itself incre ased from 4 cm to 5.5 cm in the 9 years of follow-up. Move patients di ed with their aneurysm (n=35) then underwent surgery (n=23). There was one perioperative death, and three unrelated late deaths after resect ion. One aneurysm ruptured in a patient who had refused follow-up 5 ye ars previously. Conclusions: This study suggests that aneurysms less t han 4.0 cm diameter are relatively benign, and questions the appropria teness of early intervention.