Should we screen for abdominal aortic aneurysm? Yes

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 …