TY - JOUR T1 - USe of sequential b-mode ultrasonography to manage abdominal aortic aneurysms-reply AU - LITTOOY FN, GREISLER HP, BAKER WH Y1 - 1989/12/01 N1 - 10.1001/archsurg.1989.01410120114024 JO - Archives of Surgery SP - 1464 EP - 1464 VL - 124 IS - 12 N2 - In Reply.—Dr Johnson's comments and recommendations are not entirely clear to us. Is he advocating operating on any AAA regardless of size in the low-risk patient? Our data and those of Bernstein and Chan1 strongly support the safety of following up small AAAs to at least 5 cm and perhaps even 6 cm in diameter in the high-risk patient before recommending operation. Only one AAA less than 5.0 cm in diameter ruptured in each series. Of the seven patients who had ruptured AAAs in our series, four either refused repair or were deemed too high risk and never underwent operation. Of the three patients with AAAs that ruptured, two were not operative candidates and were operated on only because the AAA ruptured while in the hospital. You may correctly argue that our operative mortality in elective aneurysm repair of 6.7% is a little high, but three of SN - 0004-0010 M3 - doi: 10.1001/archsurg.1989.01410120114024 UR - http://dx.doi.org/10.1001/archsurg.1989.01410120114024 ER -