What are the indications for referring a patient with an abdominal aortic aneurysm for surgical intervention?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
The indications for referring a patient with an abdominal aortic aneurysm (AAA) for surgical intervention are based on specific criteria for considering aneurysm repair . Surgical intervention should be considered for people with an unruptured AAA if it is:
  • Symptomatic .
  • Asymptomatic and 5.5 cm or larger (measured inner-to-inner maximum anterior-posterior aortic diameter on ultrasound) .
  • Asymptomatic, larger than 4.0 cm, and has grown by more than 1 cm in 1 year (measured inner-to-inner maximum anterior-posterior aortic diameter on ultrasound) .
Patients with an AAA that is 5.5 cm or larger should be referred to a regional vascular service to be seen within 2 weeks of diagnosis . The decision regarding repair versus conservative management is made jointly by the person and their clinician after assessing factors such as aneurysm size and morphology, the person's age, life expectancy, fitness for surgery, and any other conditions they have .

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