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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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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.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|December 25, 2025
PubMed
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.

Keywords:
AAAAbdominal aortic aneurysmCost-effectivenessESVS guidelinesIrelandPublic healthScreeningVascular surgery

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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.