Abdominal Aortic Aneurysm Screening

What is an abdominal aortic aneurysm screening?

An abdominal aortic aneurysm screening is a quick and painless ultrasound test. It checks for signs of a bulge in the part of your aorta that extends through your belly. This bulge is called an abdominal aortic aneurysm (AAA). AAA screenings help find aneurysms early. This gives your healthcare provider a chance to treat the aneurysm before it bursts (ruptures).

It’s possible to have an AAA and not realize it. That’s because AAAs can get bigger slowly and silently over many years. Most people have no warning signs or symptoms until the aneurysm ruptures. This is a medical emergency that causes internal bleeding and is usually fatal.

What are the AAA screening recommendations?

Healthcare providers recommend a one-time abdominal aortic aneurysm screening for people ages 65 to 75 at the greatest risk for an AAA. These include people who have a history of tobacco use or a biological family member diagnosed with an AAA.

Your provider may suggest an AAA screening outside this typical age range in some situations:

• If you’re under 65 with medical conditions that raise your risk for an AAA (for example, history of tobacco abuse, atherosclerosis, an aneurysm elsewhere in your body or inherited connective tissue disease)
• If you’re over 75 and have risk factors but never had a screening

Talk to your healthcare provider about whether you should have an AAA screening. You may also see an alert on your electronic health record.

How is an abdominal aortic aneurysm screening done?

Healthcare providers use an abdominal ultrasound to screen you for an AAA. This method of testing:

• Is painless
• Is noninvasive, meaning nothing goes into your body
• Doesn’t use radiation
• Only takes about 10 to 15 minutes

The test takes pictures of the inside of your belly, including your aorta. These pictures show the width of your aorta and can reveal if you have an aneurysm.

Ultrasound is an accurate way to diagnose abdominal aortic aneurysms. The Society for Vascular Surgery recommends it as the preferred imaging method for AAA screenings.

You don’t need to do anything to prepare for an AAA screening. You may want to talk with your provider about why you need the test and when you’ll receive the results.

What happens during the test?

An ultrasound technician will:

1. Ask you to lie down on an exam table and get comfortable. You’ll need to lift up your shirt so the technician can access your belly.
2. Apply a clear, cool gel over the skin on your belly. This gel helps the ultrasound waves enter your body.
3. Move a small wand over the gel to take pictures of your aorta.
4. Wipe away the gel and tell you the test is done.

An abdominal aortic aneurysm screening is safe. There aren’t any known risks.

What can I expect after the test?

You can go home right after the screening is done. Your healthcare provider will schedule a time to discuss the results with you.

Your AAA screening may show:

• No aneurysm. This means there’s no abnormal widening of your aorta. It’s the most common screening result. You likely won’t need any further monitoring for AAA.
• Aneurysm. This means there’s a bulge in your abdominal aorta. It can range in size from small to large. Your provider will tell you the size of your aneurysm and what that means for your treatment plan.

If the results are abnormal, what are the next steps?

If the screening shows you have an AAA, your provider will tell you the next steps and what you can expect. In general, if your aorta measures more than 5.5 cm (or more than 5.0 cm with additional risk factors for rupture), your provider might recommend a surgical intervention.

Otherwise, depending on the size of your abdominal aorta, your provider might recommend periodic imaging to monitor for growth of your aorta:

• 3.0 to 3.9 cm: imaging every 3 years
• 4.0 to 4.9 cm in males: imaging every 12 months
• 4.09 to 4.4 in females: imaging every 12 months
• More than 5.0 cm in males: imaging every 6 months
• More than 4.5 cm in females: imaging every 6 months

If you have an abdominal aortic aneurysm, you should tell your close biological family members. They may be candidates for screenings and should talk to their providers to learn more.

When should I call my doctor?

Call your healthcare provider if you:

• Want to learn more about AAA screenings
• Want to talk about your risk for an AAA and how to lower it
• Have questions about your AAA screening results or your treatment plan
• Have a family member diagnosed with AAA