C. Treatment
Patients with aneurysms less than 4 cm are managed conservatively and should be given a beta-blocking drug that reduces blood pressure and more important, decreases cardiac ejection velocity and hydrodynamic stress on the arterial wall. The systolic blood pressure should be kept lower than 140 mmHg, and diastolic less than 85 mmHg with the use of a beta-blocker and other antihypertensive agents. Propranolol should not be used in smokers because the drug is rendered ineffective.
Aneurysmal repair is usually indicated when aneurysms are greater than 5.5 cm because of the high risk of rupture and an overall mortality rate of more than 80%. Only 10–15% of patients survive the rupture. Patients who manage to reach a hospital have a 50% mortality rate. All vascular surgeons would recommend repair of aneurysms 6 cm or larger.

1. Surgical Treatment
Repair consists of opening of the aneurysm and insert¬ing a synthetic prosthetic tube graft, usually fabrica¬ted of Dacron or expanded polytetrafluoroethylene (Gore-Tex). Operative mortality is approximately 5% overall for effective repair, but it is less in low-risk patients. Operative mortality reaches 50% for repair of a ruptured aneurysm.

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