Rupture rates of small abdominal aortic aneurysms: A systematic review of the literature

J. T. Powell, S. M. Gotensparre, M. J. Sweeting, L. C. Brown, F. G.R. Fowkes, S. G. Thompson

Research output: Contribution to journalReview articlepeer-review

49 Citations (Scopus)


Background: Small aneurysms of the abdominal aorta (3.0-5.5 cm in diameter) often are managed by regular surveillance, rather than surgery, because the risk of surgery is considered to outweigh the risk of aneurysm rupture. The risk of small aneurysm rupture is considered to be low. The purpose of this review is to summarise the reported estimates of small aneurysm rupture rates. Methods and findings: We conducted a systematic review of the literature published before 2010 and identified 54 potentially eligible reports. Detailed review of these studies showed that both ascertainment of rupture, patient follow-up and causes of death were poorly reported: diagnostic criteria for rupture were never reported. There were only 14 studies from which rupture rates (as ruptures per 100 person-years) were available. These 14 published studies included 9779 patients (89% male) over the time period 1976-2006 but only 7 of these studies provided rupture rates specifically for the diameter range 3.0-5.5 cm, which ranged from 0 to 1.61 ruptures per 100 person-years. Conclusions: Rupture rates of small abdominal aortic aneurysms would appear to be low, but most studies have been poorly reported and did not have clear ascertainment and diagnostic criteria for aneurysm rupture.

Original languageEnglish
Pages (from-to)2-10
Number of pages9
JournalEuropean Journal of Vascular and Endovascular Surgery
Issue number1
Publication statusPublished - 2011
Externally publishedYes

Bibliographical note

Funding Information:
This project was supported by the UK National Institute for Health Research Health Technology Assessment Programme ( project 08/30/02 ). The views expressed in this paper are not necessarily those of the UK National Health Service.


  • Abdominal aortic aneurysm
  • Rupture
  • Systematic review


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