Classification, surgical-threshold check and surveillance interval — SVS 2018 (abdominal) and ACC/AHA 2022 (thoracic).
Measurement
Use the maximal outer-to-outer diameter perpendicular to the vessel axis.
cm
cm
Optional: growth rate from a prior study
cm
Result
Enter a diameter…
Report line will appear here.
Abdominal (SVS 2018 / 2022 ACC/AHA). Aneurysm ≥ 3.0 cm. Surveillance intervals are sex-specific (2022 ACC/AHA): every 3 years at 3.0–3.9 cm in both sexes; annually at 4.0–4.9 cm in men and 4.0–4.4 cm in women; every 6 months at ≥ 5.0 cm in men and ≥ 4.5 cm in women. Elective repair at ≥ 5.5 cm (men) or ≥ 5.0 cm (women), symptoms, or rapid growth (> 0.5 cm/6 mo).
Thoracic (2022 ACC/AHA). Ascending aortic dilation is defined at ≥ 4.0 cm; aneurysm at ≥ 4.5 cm (below 4.0 cm is normal calibre). No fixed interval table — re-image a newly identified aneurysm at 6–12 months to establish stability, then every 6–24 months by size, growth and etiology. Surgical thresholds: degenerative/tricuspid ≥ 5.5 cm (≥ 5.0 cm at experienced centers); Marfan ≥ 5.0 cm (≥ 4.5 cm high-risk, experienced centers); bicuspid ≥ 5.5 cm, with surgery reasonable at 5.0–5.4 cm when a risk factor for dissection is present (family history of dissection, rapid growth, aortic coarctation or root-phenotype aortopathy) and at ≥ 4.5 cm at the time of aortic valve replacement or repair. Rapid growth — an indication for intervention — is ≥ 0.5 cm in 1 year or ≥ 0.3 cm/year over 2 consecutive years for sporadic aneurysms, and ≥ 0.3 cm in 1 year for heritable thoracic aortic disease or bicuspid aortic valve.
Body size. Fixed diameter thresholds under-serve patients much smaller or taller than average. The 2022 ACC/AHA guideline states that in such patients surgical thresholds may index the root/ascending diameter to height or body surface area, or index aortic cross-sectional area to height; prophylactic surgery is reasonable when maximal cross-sectional area (cm², taken as π·(d/2)²) divided by height (m) is ≥ 10 cm²/m — applied with an experienced surgeon, and framed for heights > 1 SD above or below the mean. Enter a height above to compute this ratio for a thoracic aneurysm.
Reference only — surveillance and operative decisions are individualized. Sources: Society for Vascular Surgery AAA guideline (J Vasc Surg 2018) and 2022 ACC/AHA Aortic Disease Guideline (Circulation 2022); cross-sectional area/height ratio after Svensson et al, J Thorac Cardiovasc Surg 2003.