Ultrasonographic screening for abdominal aortic aneurysms

Frank A Lederle ¹

⁰Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA. frank.lederle@med.va.gov

Annals of Internal Medicine +

|

September 19, 2003

View abstract on PubMed

Summary

Screening older men for abdominal aortic aneurysms (AAAs) with ultrasonography can significantly reduce deaths from rupture. One-time screening is recommended for men aged 65-79 who have smoked.

Area Of Science

Vascular Surgery
Preventive Medicine
Diagnostic Imaging

Background

Abdominal aortic aneurysms (AAAs) affect 1 in 20 older men and are often asymptomatic.
Rupture of an untreated AAA leads to death in about one-third of patients.
Ultrasonography is a suitable screening tool, and elective repair can prevent rupture.

Purpose Of The Study

To evaluate the evidence for the benefit of AAA screening programs.
To determine optimal screening protocols and management strategies for AAAs.

Main Methods

Analysis of four randomized trials involving over 125,000 men undergoing ultrasonographic screening for AAA.
Review of studies on screening age, frequency, and management of detected aneurysms.

Main Results

AAA screening demonstrated a reduction in AAA-related mortality, statistically significant in two trials (21%–68% reduction).
No benefit was observed in one trial conducted in women.
Screening is recommended for men aged 65-79 who have ever smoked, with no need for repeat screening if initial results are negative.
Elective repair is recommended for AAAs >5.5 cm; smaller aneurysms require surveillance.

Conclusions

One-time ultrasonographic screening for AAA is beneficial for men aged 65-79 who have ever smoked.
Selective repair of larger AAAs maximizes screening benefits and cost-effectiveness.
Current medical treatments do not slow AAA enlargement.

Related Concept Videos