Abdominal Aortic Aneurysm Screening

What is an abdominal aortic aneurysm screening?

An abdominal aortic aneurysm screening is a quick and painless imaging test that checks for signs of an abdominal aortic aneurysm (AAA).

An AAA is a bulge in the part of your aorta that travels through your belly (abdominal aorta). AAAs can get bigger slowly and silently over many years. Most people have no warning signs or symptoms until the aneurysm bursts (ruptures). Aneurysm rupture is a medical emergency that causes internal bleeding and is usually fatal.

AAA screenings help find aneurysms early, before they rupture. This gives your healthcare provider a chance to treat the aneurysm before it ruptures so you have the best chance at survival.

Not everyone needs an AAA screening. Healthcare providers recommend this test for people most at risk of an AAA.

Who should be screened for an abdominal aortic aneurysm?

You should have an AAA screening if you:

• Are assigned male at birth (AMAB), at least 65 years old and have any history of tobacco use (defined as smoking at least 100 cigarettes in your life).
• Are at least 65 years old and any of your biological parents, siblings or children have had an AAA (regardless of your sex assigned at birth).

Your healthcare provider may also recommend a screening if you:

• Are assigned female at birth (AFAB), at least 65 years old and have any history of tobacco use.
• Are under age 65 and have multiple risk factors for an AAA or family history of the condition (regardless of your sex assigned at birth).

Talk to your healthcare provider about whether an AAA screening is appropriate for you.

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 and noninvasive. It uses high-frequency sound waves to take pictures of the inside of your body. In this case, the test captures images of the inside of your belly, including your abdominal aorta.

How do I prepare?

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:

• Have you lie down on an exam table and get comfortable. You may need to lift up your shirt so the technician can access your belly.
• Apply a clear, cool gel over the skin on your belly. This gel helps the ultrasound waves to enter your body.
• Move a small, handheld wand (transducer) over the gel to take pictures of your aorta.
• Wipe away the gel and tell you the test is done.

The test typically takes 10 to 15 minutes.

What are the risks of this test?

An AAA screening is safe with no known risks.

What do the results mean?

Your healthcare provider will discuss the test results with you. Your 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 that’s at least 50% of the normal diameter. For most people, this means a diameter of at least 3 centimeters. AAAs range in size from small to large. A large aneurysm is at least 5.5 centimeters wide (in men and people assigned male at birth) or at least 5.0 centimeters wide (in women and people assigned female at birth). 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, don’t panic. Your provider will tell you the next steps and what you can expect. Small aneurysms usually don’t require surgery. Instead, your provider will recommend surveillance. This means you see your provider at regular intervals (usually every six to 12 months) for imaging tests. Your provider will keep an eye on the aneurysm and see if it gets bigger. In some people, the aneurysm grows slowly or stays the same size. In others, it may grow more quickly. That’s why regular imaging tests are so important.

Your provider may recommend surgery if the aneurysm is large on your initial screening or it gets larger over time. Many people are candidates for endovascular aneurysm repair (EVAR). This minimally invasive procedure gives you a faster recovery than open surgery. Either way, your provider will tell you the benefits and risks of surgery and what you can expect going forward.

If screening reveals an AAA, you should inform 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 healthcare provider?

Call your 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.

A note from Cleveland Clinic

AAA screenings can be lifesaving. But sometimes, knowing you have an aneurysm can cause you to worry about the future. In most cases, small aneurysms have a very low chance of rupturing and won’t cause you any immediate danger. Your provider will closely monitor the aneurysm for signs of growth. They’ll let you know if you need treatment.

Meanwhile, try not to worry. Instead, focus on reducing your cardiovascular disease risk factors. This involves making healthy lifestyle changes and taking medications your provider prescribes. Don’t hesitate to reach out to your provider any time you have questions or concerns about your condition.