67,800 men with risk factors for abdominal aortic aneurysm were selected and divided into two groups. One group had a pain-free ultrasound scan of the abdomen. The other group was left without scanning.
After a four year period, they were followed up. Those who had this simple scan had a 42%
reduction in death rate, compared to those not screened. This study was published in The Lancet Medical Journal of November 16th, 2002.
Called the Multicentre Aneurysm Screening Study (MASS), it demonstrated, along with two other studies, that screening for the presence of abdominal aortic aneurysm saves lives. Your risk of dying from this condition could be reduced by 50%, just by having a quick 10 minutes scan.
Because screening saves lives, many countries, including the UK and US, as well as many European countries now have a National Screening Program for Abdominal Aortic Aneurysm (AAA). In the UK, the organisation saddled to carry out this program is called the NHS Abdominal Aortic Aneurysm Screening Program (NAAASP). They screen about 300,000 men yearly.
The value of abdominal aortic aneurism screening in women has been questioned. This is because rupture of an aneurysm in women usually does not happen until after the age of 80. At this point in life, there would be several other potential causes of death competing for attention.
Abdominal aortic aneurism screening is a simple pain-free ultrasound scanning of the abdomen. It is a very reliable test to detect the presence of ballooning or dilation of a part of the aorta.
The aorta is the big blood vessel that comes straight from the heart. It passes down towards the groin and divides into two to continue as the blood vessels to the legs.
On arriving for the screening, you will be:
An abdominal aortic aneurism is said to be present, when the diameter of the aorta increases by more than one and a half of the expected diameter.
At the point where the aorta enters the abdomen around the level of the eleventh rib, the size of the aorta there is about 2.5cm. This narrows off progressively to 2.1cm just above the kidneys and 1.5cm just before the aorta divides into two below the level of the umbilicus.
95% of abdominal aortic aneurysms occur just below the level of the kidney. Any localized ballooning of the aorta more than 3cm in total diameter is diagnosed as an aneurysm of the abdominal aorta.
The following are the possible results from an abdominal aortic aneurism screening:
This is when your abdominal aorta measures less than 3cm in diameter. Most people who undergoes a scan for this disease fall into this category.
If this is what is found in your case, you do not need to do anything. You would not require a follow up, unless you really want to in another 5 to 10 years time. You may have to pay to have such scanning done or get one through your family doctor or GP.
Most screening programs do not follow up or have a re-scanning facility for normal screens.
A small aneurysm is an abdominal aneurism that measures between 3 and 4.5cm.
Aneurysms expands very slowly in general, at a rate of about 2 to 3mm per year. In those with small aneurism though, an arrangement is put in place to invite them back for scanning every year to keep an eye on the rate of expansion, if any.
The occurrence of a small abdominal aortic aneurysm is often in association with other disease like high blood pressure and perhaps poor circulation. Growing body of evidence suggests that the use of Statins to treat small aortic aneurysm may reduce the rate of expansion of aneurysms.
This is certainly the scan report no one wants to see. Large aneurysms are those greater than 5cm. It is only a very few number of people who undergo scanning that are found to have large aneurysm.
If this is the case with you, it is not a bad news in total. It means that you have actually benefited from the scan. You will be referred to see a specialist who will discuss the options of treatment with you. It is not compulsory that you have a surgery if you do not want one at this moment. Remember however that there are now keyhole surgery - Endovascular repair that does not need the patient to be opened up to fix a ballooned aorta.
Well, yes. But this is very very rare and unlikely. The risk is actually not from the screening it self or the procedure itself, it is from the decision that may be reached and action that might be taken later.
In very very few patients in which an aneurysm was found ( 1 in 10,000), they will not survive surgery when they are operated upon, and would probably be alive if their aneurysm where left without operating.
That said, the benefits from an abdominal aortic aneurism screening far outweighs the risk. In the UK only, 2000 deaths are prevented every year through screening.
Sheila Arrington, Founder of Aneurysm Outreach US, promoted free abdominal aortic aneurism screening across the USA for many many years and helped saved lives.
Here is a real life case report of one of those who benefited from screening, as presented on WWL-TV - New Orleans, LA.
If you or your loved one have equally benefited from screening, or have any question on this topic, please feel free to share your thoughts here using the box below.
If you live in the USA, you can now get a one-time abdominal aortic aneurism
screening done under your Preventative Visit on your Medicare Part B (Medical
Insurance) for free as a senior.
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