When to operate on a thoracic aneurysm.

Okay, when would you operate on a thoracic aneurysm? That's also a fairly interesting question because in the inferior laorta, the cutoff for operation is around five and a half centimeters and that's based on some trials that were conducted mainly from Imperial College kind of in the beginning of the millennium. there isn't any good data for thoracic aneurysms. There was some very old data from the States, which suggested that once you get to about six centimeters, the rate of rupture increases exponentially. There's been some more data from Korea in recent years that's kind of similar. And so we have to really extrapolate the size criteria from the inferior aorta. So most people would operate on an aneurysm that was around over six centimeters. In small women, then a relatively smaller aneurysm is bigger for them proportionately so again that threshold may be altered depending on the size of the patient, but again this isn't really anything that there's hard data for, it's just a kind of consensus of experts.