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Small Abdominal Aortic Aneurysm Surveillance, Management, and Outcomes
Wiktoria Kuczmik1, David Liedl2, Damon E Houghton2
1Gonda Vascular Center, Mayo Clinic, Rochester, MN; Medical University of Silesia, Katowice, Poland.
Mayo Clinic Proceedings
|June 5, 2026
Summary
Small abdominal aortic aneurysms (AAAs) with rapid growth rates show increased risk of repair, death, and rupture. AAA growth rate significantly impacts survival and need for intervention.
Area of Science:
- Vascular Surgery
- Aortic Aneurysm Research
- Clinical Outcomes
Background:
- Small abdominal aortic aneurysms (AAAs) require careful monitoring.
- Understanding growth patterns is crucial for timely intervention.
Purpose of the Study:
- To analyze clinical characteristics of small AAAs.
- To evaluate growth patterns, rates, and associated adverse outcomes.
- To determine optimal surveillance intervals for small AAAs.
Main Methods:
- Retrospective analysis of 299 patients with small AAAs (30-45 mm).
- Patients categorized into slow-/no-, intermediate-, and rapid-growth groups.
- Assessment of time to repair, rupture, death, and influencing factors.
Main Results:
- Rapid-growth AAAs (≥5 mm/year) had higher rates of repair (88%), earlier repair, and increased mortality (79%).
- Ruptures were most frequent in the rapid-growth group (6.1%).
- Index AAA size, diabetes, and certain medications predicted time to repair.
Conclusions:
- AAA growth rate is a significant determinant of repair-free survival.
- Growth characteristics influence overall survival and rupture-free survival.
- Surveillance strategies should consider individual AAA growth rates.
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