降低不适合开放修复术患者的 AAA 相关死亡率：有来自大型随机对照临床试验的高质量证据表明，与未行修复术的患者相比，腹主动脉瘤直径为 5.5 cm 或以上、但身体状况不适合行开放修复术的患者接受腔内修复术 (EVAR) 治疗可显著降低 AAA 相关的死亡率，但 8 年后的总死亡率没有降低。然而，EVAR 后，与移植相关并发症和二次干预的比例较高。[106]Greenhalgh RM, Brown LC, Powell JT, et al; United Kingdom EVAR Trial Investigators. Endovascular repair of aortic aneurysm in patients physically ineligible for open repair. N Engl J Med. 2010 May 20;362(20):1872-80.
系统评价或者受试者＞200名的随机对照临床试验（RCT）。
降低不适合开放修复术患者的 AAA 相关死亡率：有来自大型随机对照临床试验的高质量证据表明，与未行修复术的患者相比，腹主动脉瘤直径为 5.5 cm 或以上、但身体状况不适合行开放修复术的患者接受腔内修复术 (EVAR) 治疗可显著降低 AAA 相关的死亡率，但 8 年后的总死亡率没有降低。然而，EVAR 后，与移植相关并发症和二次干预的比例较高。[106]Greenhalgh RM, Brown LC, Powell JT, et al; United Kingdom EVAR Trial Investigators. Endovascular repair of aortic aneurysm in patients physically ineligible for open repair. N Engl J Med. 2010 May 20;362(20):1872-80.
破裂：有中等质量证据表明，测量直径大于 5.0 至 6.0 cm 的动脉瘤破裂风险是 20%，在过去十年期间，英国和美国退伍军人事务部开展了 2 项前瞻性随机试验，比较了测量直径为 4.0 至 5.4 cm 肾下 AAA 中早期干预与保守观察的效果。[77]Lederle FA, Wilson SE, Johnson GR, et al; Aneurysm Detection and Management Veterans Affairs Cooperative Study Group. Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002 May 9;346(19):1437-44.[78]UK Small Aneurysm Trial Participants. Mortality results for randomized controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet. 1998 Nov 21;352(9141):1649-55.[79]Powell JT, Brady AR, Brown LC, et al; United Kingdom Small Aneurysm Trial Participants. Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002 May 9;346(19):1445-52.http://www.nejm.org/doi/full/10.1056/NEJMoa013527#t=article
系统评价或者受试者＞200名的随机对照临床试验（RCT）。
破裂：有中等质量证据表明，测量直径大于 5.0 至 6.0 cm 的动脉瘤破裂风险是 20%，在过去十年期间，英国和美国退伍军人事务部开展了 2 项前瞻性随机试验，比较了测量直径为 4.0 至 5.4 cm 肾下 AAA 中早期干预与保守观察的效果。[77]Lederle FA, Wilson SE, Johnson GR, et al; Aneurysm Detection and Management Veterans Affairs Cooperative Study Group. Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002 May 9;346(19):1437-44.[78]UK Small Aneurysm Trial Participants. Mortality results for randomized controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet. 1998 Nov 21;352(9141):1649-55.[79]Powell JT, Brady AR, Brown LC, et al; United Kingdom Small Aneurysm Trial Participants. Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002 May 9;346(19):1445-52.http://www.nejm.org/doi/full/10.1056/NEJMoa013527#t=article
