In the management of an aortic aneurysm, surgical repair is recommended when the diameter exceeds what size?

• A. 4.0 cm
• B. 6.0 cm
• C. 5.5 cm
• D. 7.5 cm

Answer: (C)

The main idea is that when to repair an aortic aneurysm is based on the risk of rupture rising with increasing size. In an asymptomatic aneurysm, elective repair is generally recommended once the diameter reaches about 5.5 cm, because at that size the rupture risk becomes high enough that the benefit of surgical intervention outweighs the risks of the operation. Additional factors can push toward earlier repair, such as rapid growth (about 0.5 cm per year or more), symptoms, or specific patient risks, but 5.5 cm is the standard threshold. The other sizes are either below this typical threshold or represent situations where different judgment calls might apply, but the common benchmark used in exams is 5.5 cm.