de Ceniga MV, Larizgoitia JB, Vélez AB, et al. - Researchers investigated octogenarian and nonagenarian patients for the natural history of small (< 55 mm) incidental abdominal aortic aneurysms (AAAs) in order to assess the necessity for follow up and/or invasive treatment. A retrospective analysis of a prospective registry yielded data of 310 patients for inclusion [256 (82.6%) men; mean index age 84.5 years (standard deviation [SD] 3.5), and median follow up period 37.9 months (interquartile range [IQR] 18.2 – 65.4)]. Findings revealed a very small risk of late rupture of small incidental AAA diagnosed in octogenarian and nonagenarian patients; the risk was especially observed when the AAA is < 40 mm in diameter. In contrast, a high global mortality is recorded. With strict selection of the patients who would benefit from follow up and eventual repair, conservative management appears sensible.