What is the recommended management for AAA greater than 5.5 cm?

The recommended management for an abdominal aortic aneurysm (AAA) greater than 5.5 cm is surgical repair. This threshold is significant because an aneurysm of this size has a substantially higher risk of rupture, which can be life-threatening.

Surgical repair can be done either through open surgery or endovascular aneurysm repair (EVAR), depending on the specific characteristics of the aneurysm and the patient’s overall health. The goal of surgery is to prevent rupture, which is associated with a high mortality rate. The decision to proceed with either open surgery or endovascular repair will take into account various factors, including the anatomy of the aneurysm, the patient’s comorbidities, age, and preferences.

In contrast, yearly ultrasound monitoring might be appropriate for smaller aneurysms (typically those under 5.5 cm), as these are less likely to rupture and can be closely watched over time. Watchful waiting is generally not an advisable strategy for larger aneurysms where the risk of immediate intervention outweighs the benefits of conservative management. While endovascular repair is a viable option for surgical intervention, the term "surgical repair" encompasses both methods, making it a more comprehensive answer for managing a AAA of this size.