Abdominal aortic aneurysm screening

Abdominal aortic aneurysm (AAA) ruptures cause 16,000 deaths a year. Randomized clinical trials on AAA screening in Europe demonstrated ultrasonography significantly reduces AAA-related mortality. As a result, AAA screening programs were developed to prevent AAA ruptures by identifying and treating patients with AAA. An AAA is defined as an aortic diameter about 1.5 times greater than a normal aortic diameter, typically ≥3.0 cm in diameter. Based on current screening data, the diagnosis of AAA is made in 4-8% of males 65-75 years of age. Much research has been invested into determining the causes of AAA development and expansion, so that screening yield of patients and management protocols for patients with AAA can be improved. This chapter discusses the screening parameters for the diagnosis of AAA, the evolution of AAA screening from the randomized screening trials to current AAA screening programs, as well as new research improving AAA screening yield and diagnosis.