Abdominal aortic aneurysm -- when should you have surgery ?

Depends: The natural history of AAA is that they enlarge and rupture. The larger, the greater the risk of rupture. When open surgery was the only option, AAA were usually repaired when they were 5-5.5 cm in diameter. With stent grafts as an option now, many vascular surgeons will fix AAA at a smaller diameter, like 4.5 cm, especially in a younger patient with a long life expectancy.