Ultrasonographic screening for abdominal aortic aneurysm in an urban community

Abstract

As part of the Birmingham Community Aneurysm Screening Project, 3500 men aged 65-75 years from 20 urban general practices were invited for aortic ultrasonographic screening at their own general practitioner's surgery; 2669 (76.3 per cent) attended. Compliance rates varied between catchment areas, from 52.1 per cent for inner-city areas to 89.6 per cent for suburbs. Successful aortic imaging was achieved in 97.3 per cent of scans. Aortic diameter > 29 mm occurred in 219 patients (8.4 per cent) and 79 (3.0 per cent) with a diameter > 40 mm were referred for vascular surgical assessment; 140 patients with an aortic diameter of 29-40 mm are currently undergoing follow-up by serial ultrasonographic examinations at intervals of 3 months at their doctor's surgery. Risk factor analysis revealed ischaemic heart disease in 21.9 per cent of men with aneurysm, compared with 11.6 per cent in those without (P < 0.001); 18.3 per cent of men with aneurysm had had a previous myocardial infarction and 13.2 per cent had peripheral vascular disease, compared with 7.4 per cent (P < 0.001) and 8.0 per cent (P < 0.01) respectively of those without. No association was found between aneurysm and hypertension or diabetes. Community-based aortic screening is an inexpensive, effective method of diagnosis of aneurysm, with high compliance from the at-risk cohort of an urban population. Such screening programmes may help to reduce the mortality rate from aortic aneurysm rupture.

Routine Ultrasound Screening for Abdominal Aortic Aneurysm among 65- and 75-Year-Old Men in a City of 200,000 Inhabitants

“…McGregor et al19 proposed an infrarenal aorta diameter >30 mm. In a pilot study including 550 men between the ages of 65 and 75 years, Smith et al 13 proposed an infrarenal diameter of 29 mm because it was three standard deviations greater than the mean diameter of 21 mm. This definition has the advantage of being based on statistical data obtained in a relatively homogeneous, controlled population.…”

The Aneurysm Detection and Management Study Screening Program

“…Our findings cast further doubt on a proposed association of AAA with chronic obstructive pulmonary disease. Several studies have reported a univariable association between AAA and chronic obstructive pulmonary disease, 13,14 and similar abnormalities in elastase activity have been observed in the two conditions. 11,12 However, in our first cohort, an association of chronic obstructive pulmonary disease with AAA of 4.0 cm or larger was lost after adjustment for number of years smoked, 2 and a Danish study has since reported similar findings.…”

Abdominal Aortic Aneurysm

“…1,2,[11][12][13][14][15][16][17][18][19][20] Male gender and increasing age are consistently identified as non-modifiable risk factors for AAA. A positive family history of AAA is reported in 1% to 5% of patients (see below).…”