Do You Have Triple-A? Screening for Abdominal Aortic Aneurysm

An abdominal aortic aneurysm (often abbreviated as AAA) is a “ballooning” of the aorta below the diaphragm. The aorta is the largest artery in the body. When your heart beats, it pumps a large amount of blood from the heart’s left ventricle directly into this blood vessel. All other arteries in the body branch off of the aorta. An aneurysm develops as a result of weakening of the wall of the artery, causing it to stretch and create the “ballooning“ effect. As you could imagine, if this balloon were to burst, it would instantly become a life-threatening issue. Up to 81% of all people who experience a rupture of an AAA do not survive.¹

The most important risk factors for development of an AAA include male sex, a history of smoking, older age, and having a first-degree relative with a history of AAA.² The other risk factors of lesser importance include high blood pressure, high cholesterol, atherosclerosis, history of aneurysms, coronary artery disease, and history of stroke, among others.^3-4

The current recommendation is that all men age 65 to 75 who have ever smoked undergo an ultrasound (sonogram) to assess the abdominal aorta. The criteria for someone qualifying as an “ever smoker“ is a lifetime history of 100 cigarettes (5 packs) or more. So, if you are a man between the ages of 65 and 75 and have smoked 100 or more cigarettes in your lifetime, screening would be recommended for you.⁵

The task force also recognizes that there is potentially a small benefit in screening men aged 65 to 75 who do not have a smoking history. Any personalized screening recommendation would be based on the other vascular risk factors (discussed above), and would be an individual consideration for those men to make with their doctor. Currently, there is a recommendation against screening women, as the harms outweigh any potential benefits.⁵

The screening test is not invasive, very accurate, and does not expose the person being screened to radiation.⁶ The test itself essentially carries no risks. If an aneurysm were to be detected, further interventions would depend on the size. Smaller aneurysms would just be monitored, but if the aneurysm was large enough then surgery might be indicated. The surgery would be undertaken if it was believed that the risk of rupture was greater than the risk of the surgery.

Overall, this screening recommendation is very straightforward. If you are reading this article and fit these criteria, definitely consider being screened, and discuss it with your doctor. Also, if you know someone who would benefit from this information, please pass it along!

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