A 68-year-old hypertensive male smoker presents with a pulsatile, expansile epigastric mass. CT angiography confirms an infrarenal abdominal aortic aneurysm measuring 5.8 cm in maximum diameter with a suitable neck for EVAR. The patient is of intermediate operative risk. What is the recommended intervention?
- A Annual surveillance ultrasonography
- B Endovascular aneurysm repair (EVAR) ✓
- C Open surgical repair (OSR) via midline laparotomy
- D Medical management with beta-blockers only
Correct answer: B. Endovascular aneurysm repair (EVAR)
Explanation
An AAA ≥5.5 cm in men (or ≥5.0 cm in women) meets the threshold for intervention. In a patient with suitable anatomy and intermediate operative risk, EVAR is preferred over open repair because of lower 30-day mortality, reduced blood loss, shorter hospital stay, and equivalent long-term survival at 10 years (EVAR-1 trial), though EVAR requires lifelong imaging surveillance.
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.