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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
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Abdominal aortic aneurysm (AAA) screening and the Irish context.
Morgan Thomas McLoughlin1, Nawar Masarani1, Mohammed Elkassaby1
1Department of Vascular Surgery, University Hospital Waterford, Co. Waterford, Ireland.
Summary
New European guidelines recommend risk-based abdominal aortic aneurysm (AAA) screening. Ireland needs updated national guidance to identify high-risk individuals effectively, particularly men aged 65+ with risk factors or family history.
Area of Science:
- Vascular Surgery
- Public Health Screening
- Epidemiology
Background:
- The 2024 European Society for Vascular Surgery (ESVS) guidelines shift AAA screening from population-based to risk-based criteria.
- This change aims to promote local adaptation, but Ireland lacks national guidance.
- Current Irish strategies do not align with updated international recommendations for abdominal aortic aneurysm (AAA) screening.
Purpose of the Study:
- To analyze the implications of the new ESVS guidelines on AAA screening.
- To compare the 2019 and 2024 ESVS recommendations.
- To emphasize the need for an updated Irish screening framework based on local data and global best practices.
Main Methods:
- Review of ESVS guidelines, systematic reviews, and cost-benefit analyses.
- International comparisons of AAA screening protocols.
- Narrative discussion focused on the Irish context and proposals for policy change.
Main Results:
- Ultrasound screening is supported for men aged 65+ with a history of smoking or atherosclerotic risk factors.
- Screening is also recommended for individuals with peripheral aneurysms or a history of organ transplantation.
- Individuals with a first-degree relative with AAA should undergo screening from age 50.
Conclusions:
- The transition to risk-based AAA screening necessitates action from national health systems.
- Ireland's current infrastructure and policies are insufficient to implement these updated guidelines.
- An interim strategy is needed to equip clinicians with knowledge for identifying high-risk individuals until a national screening program is established.
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