AAA Screening: Detecting and Preventing Abdominal Aortic Aneurysm

 

Abdominal aortic aneurysm (AAA) is a potentially life-threatening condition characterized by a bulge or swelling in the aorta, the main blood vessel that runs from the heart down through the abdomen. If not detected and treated early, AAA can lead to a rupture, causing severe internal bleeding. To mitigate this risk, AAA screening is offered to men in England during the year they turn 65. In this comprehensive guide, we will explore everything you need to know about AAA screening, its benefits, the screening process, and what happens after the screening.

Who Should Get Screened for AAA?

AAA screening is primarily offered to men aged 65 or over, as they are at the highest risk of developing an abdominal aortic aneurysm. The screening aims to identify any swelling in the aorta early on when it can be effectively treated. However, it is important to note that AAA screening is not routinely offered to women, men under 65, or individuals who have already received treatment for an AAA. The risk of developing an AAA is relatively low in these groups.

If you are over 65 and have not been offered a screening test, you can still request a scan to check for an AAA. Simply contact your local AAA screening service directly to arrange an appointment.

The Benefits of AAA Screening

The significance of AAA screening lies in its potential to save lives. Often, an abdominal aortic aneurysm presents with no obvious symptoms, making early detection crucial. If an AAA is left untreated and ruptures, the chances of survival are slim, with approximately 8 in every 10 individuals dying before reaching the hospital or during emergency surgery.

AAA screening can pick up an aneurysm before it reaches a critical stage. If an AAA is detected, you have two options: regular monitoring through scans or surgery to prevent rupture. Research suggests that AAA screening can reduce the risk of dying from an AAA by up to 50%.

Making an Informed Decision

While AAA screening offers clear advantages, it is essential to consider the potential risks and make an informed decision. The screening test itself carries no risk, but there are certain risks associated with the condition and its treatment. These include anxiety resulting from a diagnosis of a potentially life-threatening condition and the potential complications of surgical interventions.

If you decide not to undergo AAA screening, you can contact your local screening service and request to be removed from their list.

The AAA Screening Process

AAA screening is a quick, painless, and reliable procedure that involves an ultrasound scan of the abdomen. This non-invasive test is similar to the scans performed on pregnant women to assess the health of the baby. Let's take a closer look at what happens during the screening process:

1. Arrival and Registration: When you arrive for your screening appointment, a technician will check your details, explain the scan procedure, and address any questions or concerns you may have.

2. Preparing for the Scan: You will be asked to lie down on a table and lift up or unbutton your top. There is no need to undress. The technician will apply a clear gel to your abdomen and use a small handheld scanner to capture images of your aorta.

3. Scanning Process: The technician will move the scanner over your skin, and the images will be displayed on a monitor. They will measure the width of your aorta to assess for any abnormalities. The entire scanning process usually takes around 10 to 15 minutes.

4. Results and Next Steps: At the end of the test, the technician will inform you of the results. If an AAA is detected, you will receive a letter confirming the diagnosis and outlining the next steps.

In some cases, the technician may encounter difficulty in obtaining clear images of the aorta. If this happens, you may be asked to return for another scan on a different day.

Understanding AAA Screening Results

After the AAA screening, you will be given one of four possible results. Each result corresponds to a specific measurement of the width of your aorta. Let's explore the different scenarios and the recommended actions for each:

1. No Aneurysm Found

If your aorta measures less than 3cm in width, it indicates that no aneurysm is present. This is the most common result for most men. In this case, no further treatment or monitoring is required, and you will not be invited for AAA screening in the future.

2. Small AAA

If your aorta measures between 3cm and 4.4cm in width, it indicates the presence of a small AAA. Only a little over 1% of men screened fall into this category. While the risk of rupture is relatively small at this stage, regular monitoring through annual scans is recommended to track the aneurysm's size. Treatment is typically not necessary unless the AAA grows larger.

Additionally, you will receive advice on how to prevent the AAA from enlarging further. This includes measures such as quitting smoking, adopting a healthy diet, and engaging in regular exercise.

3. Medium AAA

A medium AAA is characterized by an aorta width ranging from 4.5cm to 5.4cm. Approximately 0.5% of men screened fall into this category. Similar to a small AAA, no immediate treatment is required. However, regular monitoring through scans every three months is recommended to monitor the aneurysm's progression. Treatment will only be considered if the AAA reaches a larger size.

As with a small AAA, you will receive guidance on lifestyle modifications to minimize the risk of further enlargement.

4. Large AAA

If your aorta measures 5.5cm or more in width, it indicates the presence of a large AAA. This result is relatively rare, affecting approximately 0.1% of men screened. Large AAAs carry the highest risk of rupture if left untreated. In this case, you will be promptly referred to a specialist surgeon within two weeks to discuss treatment options.

Most individuals with a large AAA are advised to undergo surgery to prevent further enlargement or rupture. While surgery carries its own set of risks, the potential complications are typically outweighed by the risks posed by an untreated large AAA.

Seeking Further Information

If you would like to learn more about the treatment options available for AAA or delve deeper into the condition itself, you can find additional information on our website. We provide comprehensive resources on abdominal aortic aneurysms, their symptoms, pathophysiology, and the latest advancements in AAA screening and treatment.

Remember, being proactive about your health and staying informed can make all the difference when it comes to preventing or effectively managing abdominal aortic aneurysms.

Page last reviewed: 12 January 2021
Next review due: 12 January 2024