At what size should aortic aneurysms be electively repaired?

Elective repair of an aortic aneurysm is typically recommended when the aneurysm reaches a size of 5.5 cm or greater. This threshold is established based on evidence indicating that the risk of rupture increases significantly at this size. The likelihood of rupture escalates dramatically as the aneurysm grows larger, making the potential benefits of surgical intervention outweigh the associated risks.

In patients with a family history of aortic aneurysms or specific characteristics such as connective tissue disorders, earlier intervention at sizes slightly lower than 5.5 cm may be considered. However, for the general population with an aneurysm that has reached the size of 5.5 cm or more, elective repair is firmly indicated to prevent rupture, as the annual risk of rupture increases substantially beyond this size.

Thus, option C accurately reflects established guidelines for the size at which aortic aneurysms should be electively repaired.