Discussion

Abstract

Whilst it is not possible to make firm recommendations regarding management strategy owing mainly to a lack of large series reporting this unusual combination of co-morbidities, the options are debated on the basis of published anecdotal evidence as well as our own case reports. We suggest that if the AAA is non-tender and/or 5.5-8.0 cm, the staged approach is appropriate. If the AAA is tender and/or > 8.0 cm, a combined approach may be a better option in order to avoid the risk of AAA rupture during the interval between the operations. Endolumenal repair of AAA offers a further option for the staged and combined approach, and may be less invasive than the standard open surgery for AAA repair.