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Examen de detección de aneurisma de la aorta abdominal: Declaración de recomendación del grupo de trabajo de

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Resumen

Se recomienda la detección de aneurismas aórticos abdominales (AAA) en hombres de 65 a 75 años que hayan fumado alguna vez. No se recomienda el cribado de rutina para mujeres sin antecedentes familiares o antecedentes de tabaquismo.

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Área de la Ciencia:

  • Cirugía vascular
  • La medicina preventiva
  • Imágenes de diagnóstico

Sus antecedentes:

  • El aneurisma aórtico abdominal (AAA) se define como el agrandamiento aórtico ≥3,0 cm.
  • La prevalencia de AAA ha disminuido en los hombres europeos examinados, pero no está clara en los Estados Unidos debido a la baja absorción de la detección.
  • Las AAA con ruptura tienen un riesgo de mortalidad del 81%, y la mayoría de las AAA son asintomáticas hasta la ruptura.

Objetivo del estudio:

  • Actualizar las recomendaciones de 2014 sobre el cribado AAA.
  • Revisar la evidencia sobre la eficacia del cribado, los daños y los beneficios del tratamiento para los AAA pequeños.

Principales métodos:

  • Revisión de pruebas encargada por el USPSTF.
  • Se centró en el cribado único y repetido de AAA.
  • Beneficios y perjuicios considerados del tratamiento de pequeñas AAA (3,0-5,4 cm).

Principales resultados:

  • Beneficio neto moderado para la detección de AAA en hombres de 65 a 75 años que alguna vez fumaron.
  • Pequeño beneficio neto para el cribado en hombres de 65 a 75 años que nunca fumaron.
  • Evidencia insuficiente para el cribado en mujeres de 65 a 75 años que fumaban o tenían antecedentes familiares.

Conclusiones:

  • Recomendar una prueba de detección de AAA por ultrasonografía para hombres de 65 a 75 años que hayan fumado alguna vez (recomendación B).
  • Ofrezca selectivamente el cribado a hombres de 65 a 75 años que nunca hayan fumado (recomendación C).
  • Recomendar contra el cribado de rutina para las mujeres de 65 a 75 años que nunca han fumado y no tienen antecedentes familiares (recomendación D).