A 58-year-old man with type 2 diabetes presents with an expanding pulsatile abdominal mass. Vital signs: BP 142/88 mmHg, HR 78 bpm, RR 16, temp 37°C, SpO2 98% on room air. Abdominal ultrasound confirms a 6 cm infrarenal abdominal aortic aneurysm without dissection or rupture. Serum creatinine is 1.1 mg/dL. He denies abdominal or back pain. He takes metformin and lisinopril. Which of the following is the most appropriate management?
- A)Conservative medical management with beta-blockers only
- B)Immediate emergency surgical repair
- C)Serial imaging surveillance with imaging every 12 months
- D)Elective open or endovascular repairGABARITO
- E)Initiate antithrombotic therapy to prevent thromboembolism
Explicação
AAA ≥5.5 cm in diameter carries significant rupture risk and warrants elective repair in asymptomatic patients. The 6 cm threshold is the indication for intervention regardless of symptoms. This prevents the 50% mortality associated with rupture. Ver explicação completa e trilha adaptativa →