Screening for an Abdominal Aortic Aneurism (AAA)

What is an Abdominal Aortic Aneurism?

Let’s break down the name to fully understand what we’re talking about. Abdomen is your stomach. Aorta is the main artery that takes blood from your heart down into the body. It’s easy to think of it as the trunk of a tree, that then branch out into your individual organs. An aneurism is a problem with the normal structure of the artery, which is caused when the walls are weakened for some reason. So to sum this all up, an Abdominal Aortic Aneurism (AAA) is the weakening of your main artery in the portion where it goes down through your stomach, causing an abnormality in the structure of the wall.

Why is it dangerous? 

The reason that this is dangerous is because of the risk of that weak wall rupturing. This can cause internal bleeding, and very quickly lead to death. That’s why it is absolutely imperative to catch this early if possible.

Who should be screen tested?

The recommendations for who should be tested rely largely on a number of different studies that have done (see the references for more information). Currently, there is strong evidence for men aged 65 to 75 who have ever smoked to be tested. Men of this age who have never smoked show weak evidence that screening actually prevents disease and mortality. There is no evidence showing us a benefit in screen testing women for AAA. The test is a simple ultrasound exam performed by a physician.

What can we do about it?

People diagnosed with an AAA should have it regularly monitored, and this is something that should be discussed with your physician. The general recommendation is for patients to undergo surgery if the aneurysm measures greater than 5-5.5cm, or if the aneurysm is growing quickly. Modern technology has created surgical techniques that are less invasive, and don’t requiring opening up your stomach in order to access your aorta. It’s important to understand the different techniques, risks and benefits, before deciding with your surgeon what is write for you.

Are these the only recommendations?

Of course not. There are many different bodies providing different recommendations. The important thing to know about what is not mentioned above is that there is a genetic factor to Abdominal Aortic Aneurisms, meaning that if you have a close family member who has had an aneurysm, screening may be recommended for you at an earlier age (above 50). This genetic recommendation holds true for The Society for Vascular Surgery, The Canadian Society for Vascular Surgery, The American Heart Association, and others.

*Please comment to us if you found this information useful, or if you have any questions about the topic.

Knowledge is power. It’s very important for each of us to understand what our options are, and what evidence supports each option. Preventing diseases before they start is often the most efficient way to be healthy, and this starts by screening for the diseases that are appropriate for us depending on age, gender, and other factors. Download our app to go through a short list of questions, and receive a personalized list of the appropriate screening recommendations for you. More information about each of these tests is provided through the app, so that you can stay informed and educated.

 
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Here are a few studies which prove the efficacy of screening and early treatment for Abdominal Aortic Aneurism. Feel free to contact us for more information about the matter, we would be happy to provide it to you.

Lin PH, Bush RL, McCoy SA, Felkai D, Pasnelli TK, Nelson JC, et al. A prospective study of a hand-held ultrasound device in abdominal aortic aneurysm evaluation. Am J Surg. 2003;186:455-9. [PMID: 14599606]

Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D, et al. Prevalence and associations of abdominal aortic aneurysm detected through screening. Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med. 1997;126(6):441-9. [PMID: 9072929]

Guirguis-Blake JM, Beil TL, Sun X, Senger CA, Whitlock EP. Primary Care Screening for Abdominal Aortic Aneurysm: An Evidence Update for the U.S. Preventive Services Task Force. Evidence Synthesis No. 109. AHRQ Publication No. 14-05202-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2014.

Lo RC, Bensley RP, Hamdan AD, Wyers M, Adams JE, Schermerhorn ML; Vascular Study Group of New England. Gender differences in abdominal aortic aneurysm presentation, repair, and mortality in the Vascular Study Group of New England. J Vasc Surg. 2013;57:1261-8. [PMID: 23384493]

Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, et al; European Society for Vascular Surgery. Management of abdominal aortic aneurysms: clinical practice guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg. 2011;41(Suppl 1):S1-58. [PMID: 21215940]

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