Abdominal Aortic Aneurysm Screening (AAA) - The Dudley Group NHS Foundation Trust

AAA screening is a simple ultrasound test free of charge to all men in the year they turn 65.

Screening is offered to detect dangerous swellings of the aorta – the primary blood vessel connecting the heart to the rest of the body. AAAs are most common in men over 65.

Aneurysms can happen in any blood vessel but one of the more common sites is the abdominal aorta. When an AAA occurs, the walls of the artery weaken, causing the blood vessel to expand and balloon out.

If expansion continues, the artery walls continue to weaken and may eventually rupture. A rupture is extremely dangerous. Around eight out of 10 people who suffer a ruptured AAA will die before they get to hospital or during surgery.

An AAA generally causes no symptoms. This means that you cannot tell if you have one, as you will not feel any pain or notice anything different.

With screening, an AAA can be detected before it ruptures.

The NHS offers screening in order to find aneurysms early so they can be checked regularly or treated if needed. The easiest way to find out if you have an aneurysm is to have an ultrasound scan of your abdomen.

Deciding to be screened

It’s up to you to decide if you want to be screened for AAA. While there are clear benefits of screening, you should also consider the possible risks.

There is no risk from the screening test itself, but there is a risk of anxiety from being told you have a life-threatening condition or complications of surgery carried out to treat an AAA.

You’ll get a leaflet with your screening invitation to help you make a decision. You can also access information at https://www.nhs.uk/conditions/abdominal-aortic-aneurysm-screening/

Please call us on 01384 321125 if you wish to discuss your options or if you wish to decline screening.

Self-Referral

Men over 65 who have not previously been screened or diagnosed with an abdominal aneurysm can request a scan by contacting the Programme on 01384 321125.

Your Appointment

Screening for AAA involves a quick and painless ultrasound scan of your abdomen. This is similar to the scan pregnant women have to check on their baby.

When you arrive for your appointment, a screening technician will check your details, explain the scan and ask if you have any questions.

For the scan you will lie down on a couch and lift up or unbutton your top (you don’t need to undress).

The technician will squeeze a small amount of clear gel on your abdomen and will move a small handheld scanner over your skin.

Pictures from the scanner are shown on a monitor and the technician will measure how wide your aorta is.

Your results will be given to you during the appointment.

The whole test usually takes about 10 minutes.

Sometimes the technician might not be able to see your aorta clearly. This isn’t anything to worry about. If this happens, you’ll be asked to have another scan, usually on a different day or you may be asked to come to the X-Ray department of the hospital to be screened.

Results of AAA screening

There are four possible screening results.

No Aneurysm

No aneurysm has been found. If your aorta is less than 3cm wide, this means you do not have an aneurysm.

No treatment or monitoring is needed afterwards. You will not be invited for AAA screening again because an AAA grows slowly and the chances of you developing one after the age of 65 are very small.

Small AAA

If you have a small AAA, this means your aorta measures 3cm to 4.4cm across. Just over 1% of men screened have a small AAA.

You won’t need any treatment at this stage as the chance of the AAA bursting is small. You’ll be invited back for a scan every year to check its size. Treatment will usually only be needed if it becomes a large AAA.

You’ll also be invited to a Nurse Assessment appointment at your local hospital where you will be given advice on how you can stop an AAA getting bigger, such as stopping smoking, eating healthily and exercising regularly. Any medication you take will also be reviewed.

Medium AAA

If you have a medium AAA, this means your aorta measures 4.5cm to 5.4cm across. About 0.5% of men screened have a medium AAA.

You won’t need any treatment at this stage as the chance of the AAA bursting is small. You’ll be invited back for a scan every three months to check its size. Treatment will usually only be needed if it becomes a large AAA.

Large AAA

If you have a large AAA, this means your aorta measures 5.5cm or more. About 0.1% of men screened have a large AAA.

As large AAAs are at the highest risk of bursting we will give you an appointment with a specialist vascular team to have more scans and talk about possible treatment.

Most men with a large AAA are advised to have surgery to stop it getting bigger or bursting. While surgery carries a risk of complications, this is generally smaller than the risk of not treating a large AAA.