ABC of Vascular Disease

Aortic Aneurysm Screening

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1. What is screening?
Screening is a method of detecting potentially life threatening health problems before they become serious so that they can be treated early and complications prevented.  There are many types of screening, many of which are for cancer (e.g. breast cancer and cervical cancer in women) but any serious illness may benefit from screening.

2. Why screen for aortic aneurysms?
Aortic aneurysms are quite common and usually do not cause any symptoms until they leak (Aortic Aneurysm). If an aortic aneurysm is allowed to leak the chance of the person surviving is around 1 in 10.  If the aneurysm is detected before it leaks it can be repaired and, although this is a major operation, the chance of survival is nearer 19 out of 20 .... much better odds!  The likelihood that an aortic aneurysm will leak is related to its size: an aneurysm greater than 5.5 cm should be considered for repair.

3. Who should be screened?
Aortic aneurysms are much more common in elderly men and it is this group who stand to benefit most from aortic screening.  The current recommendation is that all men at 65 years of age would benefit from screening.

4. How is the screening done?
A simple, quick and painless examination of the tummy using an ultrasound machine is all that is needed.  The ultrasound machine can "see" the aorta and measure how wide it is. What is done after the first examination depends on how big the aorta is

bulletIf the aorta is normal (less than 3 cm in diameter) the chance of developing an aneurysm late is very low and no further scans need to be done.
bulletIf the aorta is between 3 cm and 4 cm then it should be monitored at yearly intervals to see how fast it is growing but an operation is not advised.
bulletIf the aorta is between 4 and 5 cm then it is monitored every six months but an operation is not yet recommended.
bulletIf the aorta exceeds 5 cm then a surgical repair should be considered and this is the time that a vascular surgeon will consider the best course of action for each individual patient.
bulletIf the aorta exceeds 6 cm an urgent surgical repair should be considered because the risk of aneurysm rupture is getting unacceptably high.

5. What if I don't want screening?
Everyone is free to decline screening and if you change your mind later then it won't affect your treatment.  If you do have an aneurysm it may be picked up in time to be treated. If the aneurysm leaks then an emergency operation would be needed.  Of course, people can get ill from other causes.

6. Where can I go to get screened?
Some places have screening programs set up already and if so you will be invited automatically to attend.  If not then you just need to ask you GP to arrange a screening ultrasound examination at your local hospital.

S.R.Dodds 2006