Ultrasound Screening for Abdominal Aortic Aneurysms Saves Men's Lives

Regular ultrasound screening for abdominal aortic aneurysms (AAAs) can sharply reduce the likelihood of dying from a ruptured aneurysm among men age 65 and older, according to a review of recent studies.

Screening helped decrease the likelihood of death by almost 50% for men ages 65 to 79 but did not reduce deaths among women. However, men who received screening were also twice as likely to undergo surgery for the condition, a procedure that carries its own risk of death, according to Dr. Paul Cosford, from the East of England Strategic Health Authority (Cambridge, UK).

The four studies included 127,891 men and 9,342 women. The study was conducted by Dr. Cosford and Dr. Gillian Leng from the U.K. National Institute for Clinical Excellence (London, UK), and was published in the latest issue of Cochrane Database of Systematic Reviews (2007; issue 2), a publication of The Cochrane Collaboration, an international organization that evaluates medical research.

Aneurysms are places in the aorta that have become wider as the large blood vessel travels through the abdomen. As the artery balloons out at a specific area, the aorta walls become weaker, increasing the odds that it will burst. A burst aorta is frequently fatal; almost 80% of individuals who reach a hospital after the aorta ruptures will die.

Screening could help save many of these lives, since surgeons can repair an aneurysm before it bursts, typically before it grows larger than two inches in diameter. However, screening for these aneurysms is to some extent controversial, since "the balance between risk of rupture and risk of elective surgical repair is difficult to judge for people who are healthy,” Dr. Cosford said. "Patients may therefore be asked to undergo this risk to repair a large aneurysm which may not kill them,” he stated, adding that some individuals may also become "significantly anxious” about smaller aneurysms that do not need surgery.

In 2007, U.S. Medicare began offering abdominal aortic aneurysm screening for those in the United States at high risk for the condition, including men over 65 who have smoked and women with a family history of aneurysms. If the initial screening demonstrates an aneurysm, the reviewers reported that current practice is to perform a repeat ultrasound every three to six months for aneurysms smaller than 5 cm.

Although evidence suggests that the risk of abdominal aortic aneurysm is higher in men than women, according to Dr. Cosford, researchers need to find out more about the advantages and disadvantages of screening in women.


Related Links:
East of England Strategic Health Authority
U.K. National Institute for Clinical Excellence