近期，美国血管外科协会陆续在《Journal of Vascular Surgery》杂志上就腹主动脉瘤治疗中的几个令人关注的问题给出了他们的建议，并且提出了一些争议点以及未来的方向，小编将为大家一一呈现。
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2. Ulug P, Powell JT, Martinez MA, BallardDJ, Filardo G. Surgery for small asymptomatic abdominal aortic aneurysms.Cochrane Database Syst Rev 2020;7:CD001835.
3. Parkinson F, Ferguson S, Lewis P,Williams IM, Twine CP; South East Wales Vascular Network. Rupture rates ofuntreated large abdominal aortic aneurysms in patients unfit for electiverepair. J Vasc Surg 2015;61:1606-12.
4. Powell JT, Gotensparre SM, Sweeting MJ,Brown LC, Fowkes FG, Thompson SG. Rupture rates of small abdominal aorticaneurysms: a systematic review of the literature. Eur J Vasc Endovasc Surg2011;41: 2-10.
5. Chaikof EL, Dalman RL, Eskandari MK,Jackson BM, Lee WA, Mansour MA, et al. The Society for Vascular Surgerypractice guidelines on the care of patients with an abdominal aortic aneurysm.J Vasc Surg 2018;67:2-77.e72.
6. Vorp DA, Vande Geest JP. Biomechanicaldeterminants of abdominal aortic aneurysm rupture. Arterioscler Thromb VascBiol 2005;25: 1558-66.
7. Lo RC, Lu B, Fokkema MT, Conrad M, Patel VI,Fillinger M, et al. Relative importance of aneurysm diameter and body size forpredicting abdominal aortic aneurysm rupture in men and women. J Vasc Surg 2014;59:1209-16.
Society for Vascular Surgery implementationof guidelines in abdominal aortic aneurysms: preoperative surveillance and threshold for repair
Rae S. Rokosh, Winona W. Wu, Mark K.Eskandari, and Elliot L. Chaikof 1. 无症状的真性腹主动脉瘤的干预仍依据超声，CTA或MRI上测量到的 主动 脉 最大 外径：- 推荐在垂直于CTA三维重建中心线的横断面上进行直径测量
- CT横断面上短轴的距离最接近最大瘤体直径 [1]
- 男性真性AAA患者≥5.5cm（1A级证据）
- 女性真性AAA患者≥5cm（2B级证据）
- 囊性动脉瘤
- 没有考虑瘤壁血栓或潜在的几何学及生物力学因素可能影响AAA进展直至破裂 [6]
- 没有考虑女性更小的基线主动脉直径
- 验证并运用主动脉大小指数或许可以帮助明确瘤径＜5.5cm能够从早期干预中获益的女性
- 未来的指南应该阐明囊性动脉瘤，以及结缔组织病导致的AAA或夹层动脉瘤的术前监测方案和干预指证
