The Correct Answer is A!

 

A 78-year-old woman has severe COPD, HTN, and DM with stable exertional angina. She is limited by her lung disease and on supplemental oxygen. She was found to have an infrarenal AAA of 5.1 cm.

What is the next step in management?

A. Monitor every 6-12 months
B. Open surgical repair
C. Endovascular repair
D. Coronary angiography and then decide on surgical or endovascular repair

Rationale:

Patients with infrarenal or juxtarenal AAAs measuring 4.0 to 5.4 cm in diameter should be monitored by ultrasound or computed tomographic scans every 6 to 12 months to detect expansion. Intervention is not recommended for asymptomatic infrarenal or juxtarenal AAAs if they measure less than 5.0 cm in diameter in men or less than 4.5 cm in diameter in women. In high-risk patients, intervention should be withheld unless there is rapid growth or size is >5.5 cm.

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