ABDOMINAL AORTIC ANEURYSM - THE IMPORTANCE AND BENEFITS OF SCREENING
An abdominal aortic aneurysm (AAA) is the enlargement of the main artery that runs from the heart to the abdomen. Screening for an abdominal aortic aneurysm checks whether there is a bulge in the blood vessel. Spotting an AAA is crucial as it could get bigger and cause serious complications when it eventually bursts. The condition is the 10th leading cause of death in men over 55.
Tests to identify an abdominal aortic aneurysm include an abdominal ultrasound, a CT scan, and an MRI. The U.S. Preventive Services Task Force advises screening for male smokers (or ex-smokers) between the ages of 65 and 75. Talk to your healthcare provider about an ultrasound screening if you have a high risk of developing an AAA.
Who Should Be Screened?
The following conditions can weaken areas in your blood vessels, placing you at risk of developing aneurysms:
- Plaque buildup inside your arteries or atherosclerosis.
- Peripheral artery disease (PAD).
- Tobacco use reduces the structural proteins in the artery wall, which weakens the wall.
- Cardiovascular diseases.
- Traumatic injuries that rupture the artery wall.
- Vasculitis (inflammation of blood vessels).
According to research, abdominal aortic aneurysms may also have genetic linkages. Some connective tissue-related genetic disorders, such as Ehlers-Danlos type IV or Marfan syndrome, can also weaken or harm blood vessels.
The United States Preventive Services Task Force (USPSTF) recommends that men aged 65 to 75 who were smokers should undergo a single AAA ultrasonography screening. In England, men who are 65 years old are eligible for AAA screening.
Abdominal aortic aneurysm screening is not usually offered to:
- Men under 65
- Those who have received AAA treatment
This is because of the much lower risk of developing the condition in these groups.
If you are over 65 and believe you require screening, you can request a scan. For men between 65 to 75 years who have never smoked, your doctor may selectively offer screening for AAA with ultrasonography rather than routine screening. Again, your medical history, personal values, family history, and other risk factors may be considered.
Benefits Of Screening
An abdominal aortic aneurysm frequently manifests with few or no symptoms, but if it grows larger, it could rupture and result in life-threatening internal bleeding.
Eight out of ten people who experience a burst AAA perish before reaching a hospital or do not make it through emergency surgery to repair it.
If an abdominal aortic aneurysm is discovered during screening, you can opt for either surgery to prevent it from bursting or have routine scans to monitor it. The screening test is rapid, comfortable, and accurate. According to research, it can reduce the mortality risk from AAA by 50%.
While screening has unquestionable advantages, the decision to opt for it should be made, realizing that a potentially fatal diagnosis can lead to anxiety.
What Are The Screening Tests?
A doctor will examine you and look over your medical and family history to determine whether you have an abdominal aortic aneurysm. Then, imaging tests are done to confirm the diagnosis if your doctor suspects you may have the condition.
The following tests are used to identify abdominal aortic aneurysms:
1. Abdominal ultrasound (USG):
This is the most frequently used test to identify abdominal aortic aneurysms. A non-invasive procedure using sound waves, an abdominal ultrasound shows blood flow through the aorta and other abdominal organs.
2. Abdominal MRI:
This imaging test uses a magnetic field and radio waves generated by a computer to obtain finely detailed images of the interior organs in your abdomen. In addition, dye (contrast material) may occasionally be administered through a vein to make your blood vessels more visible.
3. CT scan of the abdomen:
X-rays are used in this painless examination to produce cross-sectional images of the structures inside the abdominal region. It is employed to produce precise images of the aorta. An abdominal CT scan can potentially reveal the size and shape of an aneurysm.
What To Expect?
Screening personnel will check your information, go over the scan, and ask you if you have any questions when you arrive for your appointment.
Screening for an abdominal aortic aneurysm involves a painless and quick ultrasound scan of your belly. A healthcare provider will measure the width of your aorta after applying a clear gel to your abdomen and moving a small handheld scanner over it. The gadget communicates with a computer, and the images from the scanner are displayed on a monitor.
You will be asked to lie down on a table that slips inside a doughnut-shaped machine for the CT scan. Occasionally, a dye (contrast material) is injected into a vein to enhance the visibility of your blood vessels in the images.
The healthcare provider will immediately inform you of the result. Typically, the entire test lasts between 10 and 15 minutes. They might occasionally be unable to see your aorta clearly.
If this happens, another scan will be required, usually on a different day.
Results Of Screening
There are four potential screening outcomes.
1. No aneurysm
If your aorta is less than 3 cm wide, it is not enlarged. This is common, and you would not require further care or observation. In addition, you won't be invited to another AAA screening.
2. Small-sized aneurysm
You have a small abdominal aortic aneurysm if your aorta is 3 to 4.4 cm in diameter. Over 1% of the men who were screened have a minor AAA. Since there is little chance that the AAA will burst at this point, you do not need any treatment.
You will be advised to repeat the scan yearly to determine its size. Treatment is typically only required if it develops sizeably. You will also receive advice on preventing enlargement, such as quitting smoking, following a healthy diet, and exercising regularly.
3. Medium-sized aneurysm
If your aorta is between 4.5 and 5.4 cm in diameter, you have a medium-sized AAA, which is prevalent in about 0.5% of the screened men. Since there is little chance that the aneurysm will burst at this point as well, you would not need any treatment.
You will be advised to undergo a scan every three months to determine if it is growing in size. Treatment is typically only required if it enlarges considerably. You will be advised to quit smoking, consume a balanced diet, and exercise regularly to prevent the abdominal aortic aneurysm from growing larger.
4. Large-sized aneurysm
If you have a large AAA, your aorta must be at least 5.5 cm wide. The percentage of men with such a condition is about 0.1%.
You will be referred to a specialist surgeon in less than two weeks of your diagnosis to discuss your treatment options because large abdominal aortic aneurysms have the highest risk of bursting if left untreated.
Surgery is recommended for most men with a large aneurysm to prevent it from growing or bursting. Although there is a risk of serious complications following surgery, this is typically lower than the risk of leaving the condition untreated.
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