Small Abdominal Aortic Aneurysm Surveillance, Management, and Outcomes

Document Type

Article

Publication Date

6-5-2026

Department

Department of Biomedical Engineering

Abstract

Objective: To assess the clinical characteristics of small abdominal aortic aneurysms (AAAs) for growth patterns, growth rates, time to repair, and adverse outcomes relative to surveillance imaging intervals. Patients and Methods: Patients with small AAAs (30-45 mm in diameter) and at least 1 follow-up imaging study were eligible for inclusion (January 1, 2014, through December 31, 2019). Variables impacting time to repair, rupture, or death were assessed. Results: Of 2044 unique patients with AAAs, a random sample of 299 patients (mean ± SD age, 70.5 ± 9.0 years; 18.7% female) were divided into slow-/no- (≤2 mm per year; n=116), intermediate- (>2 to < 5 mm per year; n=150), and rapid- (≥5 mm per year; n=33) growth categories. During 10.0-year median follow-up, 61.2% of the patients (n=183) underwent repair. Rapid-growth AAAs were more likely to undergo repair (88% vs intermediate 81.7% or slow/no growth 26.5%; P< .001), required earlier repair (P< .001), and were more likely to die during follow-up (79% vs 41% or 56%; P=.045). Predictors of time to repair included index AAA size, diabetes mellitus, and β-blocker or diuretic therapy. Ruptures (n=1) or impending ruptures (n=4) during follow-up were greatest in the rapid- (n=2, 6.1%; P< .001) compared with the intermediate- (n=3, 2.0%) or slow-/no- (0%) growth groups. Conclusion: Growth rate characteristics of AAAs influence repair-free survival, time to repair, overall survival, and rupture-free survival.

Publication Title

Mayo Clinic Proceedings

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