AAA ultrasound screening
DEUltraschall-Screening auf Bauchaortenaneurysma
AAA screening uses a single bedside abdominal ultrasound to measure the widest part of your infrarenal aorta. An abdominal aortic aneurysm (AAA) is defined as 3 cm or more. The 2019 USPSTF statement gives a Grade B recommendation for one-time screening in men aged 65 to 75 who have ever smoked. (It is Grade C for never-smokers in that age band, and Grade D against routine screening in non-smoking women with no family history.) The recommendation rests on the UK Multicentre Aneurysm Screening Study (MASS). That study showed a 48% relative cut in AAA-related death at 10 years, in invited men aged 65 to 74. Ultrasound is radiation-free, cheap, and highly sensitive. If an AAA is found, you get surveillance scans, with the interval set by the diameter. Elective repair is typically considered at 5.5 cm or more in men. In Germany, statutory health insurance has funded a single screening ultrasound for men aged 65 and older since 2018.
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Sources
- Owens DK, Davidson KW, Krist AH, et al.. (2019). Screening for Abdominal Aortic Aneurysm: US Preventive Services Task Force Recommendation Statement. *JAMA*doi:10.1001/jama.2019.18928
- Thompson SG, Ashton HA, Gao L, Scott RAP, on behalf of the MASS Group. (2009). Screening men for abdominal aortic aneurysm: 10 year mortality and cost effectiveness results from the randomised Multicentre Aneurysm Screening Study. *BMJ*doi:10.1136/bmj.b2307
- Chaikof EL, Dalman RL, Eskandari MK, et al.. (2018). Editorial Comparison: AAA screening guidelines United States Preventative Services Task Force and Society for Vascular Surgery. *Journal of Vascular Surgery*doi:10.1016/j.jvs.2017.10.044