UK Small Aneurysm Trial

UK Small Aneurysm Trial — early elective surgery versus ultrasonographic surveillance

Patient / Population Intervention / Exposition Vergleich Endpunkt

In 1,090 patients aged 60–76 years with a symptomless abdominal aortic aneurysm of 4.0–5.5 cm, early elective open repair did not reduce long-term all-cause mortality compared with ultrasonographic surveillance.

1.090

Design

Open-label RCT, mean follow-up 4.6 years

Endpunkt

All-cause mortality

Relevanz

ErgebnisHR 0.94 (95 % CI 0.75–1.17; p=0.56), with no difference at 2, 4 or 6 years. 30-day operative mortality in the early-surgery arm was 5.8 %, producing an early survival disadvantage.

UK Small Aneurysm Trial Participants. Lancet. 1998;352(9141):1649-1655. 10.1016/S0140-6736(98)10137-X

Diskussion & Kritik

Open repair only, at an operative mortality that would be lower today, and it predates endovascular repair entirely. It is the foundational trial that fixed the 5.5 cm intervention threshold and legitimised surveillance below it.