A 68-year-old male smoker is found on screening ultrasonography to have an infrarenal abdominal aortic aneurysm (AAA) of 5.6 cm diameter. He is asymptomatic and medically fit. Current UK NICE and ESVS guidelines recommend elective repair at diameter threshold of:
- A ≥4.0 cm in all patients
- B ≥5.5 cm for men or expansion >1 cm/year, ≥5.0 cm for women ✓
- C ≥5.0 cm for women, ≥5.5 cm for men
- D ≥6.0 cm irrespective of sex
Correct answer: B. ≥5.5 cm for men or expansion >1 cm/year, ≥5.0 cm for women
Explanation
Current ESVS and NICE guidelines (2022–2023) recommend elective repair for infrarenal AAA when: diameter ≥5.5 cm in men or ≥5.0 cm in women (lower threshold due to sex-related proportional size differences), or growth rate >1 cm/year regardless of absolute size. This 68-year-old man with 5.6 cm AAA meets the male threshold and should be offered EVAR (preferred) or open repair depending on anatomy, fitness, and center expertise.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.