[Small aneurysms of the abdominal aorta]

As "small" an aneurysm of the abdominal aorta is defined, the diameter of which is < 5 cm in the maximal anteroposterior or transverse diameter. The authors investigated the development of a small aneurysm of the abdominal aorta in a group of 55 patients for a period of 30 months. They evaluated also the influence of the main risk factors and firmness of the thrombus on the growth rate of the aneurysm. A statistically highly significant factor for the growth of the aneurysm was untreated hypertension (p < 0.0001). Other factors (age, smoking, diabetes, ischaemic heart disease) were not significant for the development of the aneurysm. The firmness of the thrombus correlated with its size but was not directly related to the rate of enlargement of the aneurysm. Based on their own experience and reports in the literature the authors assume that elective surgery or endovascular treatment is indicated in patients where the growth of a small aneurysm exceeds 0.5 cm in six months and also patients where the aneurysm has reached the size of 5 cm during regular check-up examinations. Untreated or inadequately treated hypertonic patients with an aneurysm 4-5 cm in diameter should be indicated for surgery sooner. The question remains whether to indicate for early surgery patients with an unchanging diameter of an aneurysm who are in a good general condition without serious risks. Elective surgery is indicated in these aneurysms in view of the low incidence of ruptures only in departments where the surgical mortality is substantially lower than 5%.