The Canadian Society for Vascular Surgery (CSVS) has identified unnecessarily frequent ultrasound exams in asymptomatic patients with small abdominal aortic aneurysms (AAAs) as one of its five specific tests and treatments to question under the Choosing Wisely Canada campaign.
CSVS instead recommends that aneurysms smaller than 4.5 cm in diameter should undergo ultrasound surveillance every 12 months in these patients. The other four recommendations on the list are as follows:
- Don't perform percutaneous interventions or bypass surgery as first-line therapy in patients with asymptomatic peripheral arterial disease (PAD) and in most patients with claudication.
- Don't perform carotid endarterectomies or stenting in most asymptomatic high-risk patients with limited life expectancy.
- Don't perform open or endovascular repair in most asymptomatic patients with small AAAs (< 5 cm in women, < 5.5 cm in men).
- Don't perform endovascular repair of AAAs in most asymptomatic high-risk patients with limited life expectancy.
