Result card

  • CUR14: How should AAA be managed according to published algorithms/guidelines?
Abdominal Aorta Aneurysm Screening
A0016
English
Guidance

How should AAA be managed according to published algorithms/guidelines?

Authors: Pseudo218 Pseudo218, Pseudo73 Pseudo73

Internal reviewers: Paolo Giorgi Rossi, Lotte Groth Jensen

Open surgery

“Open repair of AAAs may result in significant risk of operative mortality as well as such adverse outcomes as cardiac, pulmonary and other complications. Open repair is associated with better outcomes when performed by specialty surgeons in high-volume hospitals” {18}

Endovascular surgery

“EVAR {endovascular aneurysm repair} appears to reduce short-term morbidity and mortality compared to open repair and may be the preferred procedure for intact AAA repair in some patients. Long-term complications, including AAA rupture and the need of subsequent open repair, may result in significant long-term morbidity and mortality.” {18}

Elective repair

“For 4.0-5.4 cm AAAs, immediate surgical repair, compared to surveillance with delayed repair, does not appear to improve either AAA-related mortality or all-cause mortality”{18}

Rescreening for AAA

“Periodic surveillance appears reasonable for those with 3.0-3.9 cm AAAs, which have a very low risk of rupture” {18}

Medical therapy for individuals where surgery is not indicated

Smoking cessation

Reduction of cardiovascular risk factors

Statin therapy

Antiplatelet therapy

Beta blockers

Antibiotics {Mohler, Nat}

Guideline

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines{29}

Guideline: Work in progress


Pseudo218 P, Pseudo73 P Result Card CUR14 In: Pseudo218 P, Pseudo73 P Health Problem and Current Use of the Technology In: Jefferson T, Vicari N, Frønsdal K [eds.]. Abdominal Aorta Aneurysm Screening [Core HTA], Agenzia nationale per i servizi sanitari regionali (age.na.s), Italy; 2013. [cited 28 May 2023]. Available from: http://corehta.info/ViewCover.aspx?id=106

References

{18} Fleming C, Whitlock EP, Beil TL, Lederle FA. Screening for abdominal aortic aneurysm: a best-evidence systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2005 Feb 1;142(3):203-11.

{29} Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA,SicardGA, et al. The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. J Vasc Surg. 2009 Oct;50(4 Suppl):S2-49.