BMJ  2008;336:862 (19 April), doi:10.1136/bmj.39517.443796.AD

Head to Head

Should we screen for abdominal aortic aneurysm? Yes

¹ Whipps Cross University Hospital, London E11 1NR

In January, the government announced five pilot screening programmes for aortic aneurysm in men aged 65 in England. Stephen Brearley describes the rationale for this proposal while James Johnson (doi: 10.1136/bmj.39514.494167.AD) argues that it is not without pitfalls

The first 150 words of the full text of this article appear below.

Around 5% of men aged between 65 and 74 have abdominal aortic aneurysms (maximum infrarenal aortic diameter of at least 3 cm).¹ The prevalence is some six times lower in women. Aneurysms expand inexorably² without causing symptoms until they rupture or the individual dies of another cause. When rupture occurs, barely half of the patients reach hospital alive.³ Of those who do, 40-60% do not survive to discharge, giving an overall mortality for ruptured aortic aneurysm in the region of 80%. Nearly 5000 people die of this condition each year in England and Wales.⁴

Some aneurysms are diagnosed before rupture occurs, but at present this is largely fortuitous. Conventional open repair of unruptured aneurysms below the renal arteries (95% of the total) carries a mean mortality of 9.5%,⁵ although recent UK series have reported mortalities of 5.5%, 6%, and 4.2%.^{2 5 6} Endovascular repair of aneurysms in the 60-70% of patients for . . . [Full text of this article]

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This article has been cited by other articles:

• Forsdahl, S. H., Singh, K., Solberg, S., Jacobsen, B. K. (2009). Risk Factors for Abdominal Aortic Aneurysms: A 7-Year Prospective Study: The Tromso Study, 1994-2001. Circulation 119: 2202-2208 [Abstract] [Full text]  
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