March 20, 2026

What Are the Treatment Options for an Abdominal Aortic Aneurysm (AAA)?

An abdominal aortic aneurysm (AAA) is a serious vascular condition that develops when a weakened section of the abdominal aorta gradually enlarges. Because the aorta is the body’s main blood vessel, an untreated aneurysm can rupture and become life-threatening. Understanding how AAAs develop, how they are diagnosed, and when treatment is necessary can be lifesaving.

In New York City, patients with complex vascular disease often seek care from Dr. Alan Benvenisty, a board-certified vascular surgeon with extensive experience diagnosing and treating abdominal aortic aneurysms.

How an Abdominal Aortic Aneurysm Develops

An AAA forms when the wall of the abdominal aorta weakens and begins to bulge outward. Over time, pressure from blood flow causes the aneurysm to expand. Many aneurysms grow slowly and without symptoms, which is why AAAs are often called “silent” conditions.

Risk factors for developing an AAA include:

• Age over 65
• Smoking history
• High blood pressure
• Atherosclerosis (plaque buildup)
• Family history of aneurysms

Studies estimate that up to 5% of men over age 65 have an abdominal aortic aneurysm, making screening especially important for at-risk individuals.

How AAA Is Diagnosed

Most abdominal aortic aneurysms are discovered during imaging tests performed for other reasons or through routine screening. Ultrasound is commonly used as a first-line screening tool, while CT scans provide detailed measurements of the aneurysm’s size and growth rate.

Diagnosis focuses on determining:

• The exact size of the aneurysm
• Whether it is growing over time
• Signs of wall weakness or rupture risk

Small aneurysms may be monitored, while larger or expanding aneurysms often require intervention.

When Is Treatment Necessary?

Not all AAAs require immediate surgery. However, treatment becomes necessary when certain risk thresholds are met. Immediate intervention is recommended if:

• The aneurysm is actively bleeding
• The diameter reaches a critical size (typically around 5.5 cm)
• The aneurysm is growing rapidly
• The patient develops symptoms such as abdominal or back pain

At this stage, the risk of rupture outweighs the risks of surgery.

Open Surgical Repair

Open repair is the traditional treatment for abdominal aortic aneurysms. This procedure involves making an abdominal incision and replacing the weakened section of the aorta with a synthetic graft.

Open repair is often recommended for:

• Younger patients
• Patients with complex aneurysm anatomy
• Cases where endovascular repair is not feasible

While highly durable, open surgery requires a longer hospital stay and recovery period.

Endovascular Aneurysm Repair (EVAR)

Endovascular repair uses a stent graft placed inside the aneurysm through small incisions in the groin. This approach reinforces the aorta from within and redirects blood flow away from the weakened area.

EVAR is generally preferred for:

• Older patients
• Patients with additional medical conditions
• Those seeking shorter recovery times

Research shows EVAR offers lower short-term complication rates and faster recovery compared to open surgery, though long-term monitoring is required.

Expert AAA Care in NYC

Dr. Alan Benvenisty is board certified in both general surgery and general vascular surgery and brings deep expertise to the management of abdominal aortic aneurysms. His approach focuses on selecting the safest and most effective treatment option based on each patient’s anatomy, health, and risk factors.

Take Action Before an AAA Becomes an Emergency

Early diagnosis and expert treatment planning are critical for preventing aneurysm rupture. If you have risk factors for AAA or have been diagnosed with an aneurysm, timely evaluation can save your life.

Contact Dr. Alan Benvenisty, MD, in NYC to schedule a consultation and learn which abdominal aortic aneurysm treatment option is right for you.