LAUSR

Landmark trials of surgery for small abdominal aortic aneurysms (AAA), which included patients with AAA sizes between 40 and 55 mm, did not demonstrate medium term survival benefits of early surgery in these patients [1]. However, these trials also showed the variation in AAAgrowth rates between individuals, and that themajority of patients with small AAAs would eventually progress to the threshold of 55 mmwithin 5 years. In the ensuing decades since these trials,we havewitnessed changes in the epidemiology of AAA. Patients are being diagnosed with AAAs at an increasingly older age [2]. The operative risk for AAA surgery has also improved internationally according the data from large registries [3,4]. It is therefore a logical hypothesis that those patients with expected fast future growth of AAA may benefit from early surgery before they reach the 55 mm threshold. Although several putative markers of AAA progression have been reported, none has yet been validated for use in clinical practice [5,6]. More research will be required to advance knowledge in this specific arena. Given the finite research resources available, it is imperative for researchers to demonstrate the need for specific research, and a clear path to translate their findings to impact clinical practice. Initiatives such as the James Lind Alliance utilise consultation with clinicians and