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abdominal aortic aneurysm: should i get a screening test?
you may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
abdominal aortic aneurysm: should i get a screening test?
1get the | 2compare | 3your | 4your | 5quiz | 6your summary |
get the facts
your options
- get a screening test for abdominal aortic aneurysm.
- don't get a screening test.
if you already have symptoms of an abdominal aortic aneurysm and your doctor suspects that you have one, this topic is not for you. your doctor will want you to have the test.
key points to remember
- most abdominal aortic aneurysms, or aaas, never cause problems. but sometimes they burst, which is often deadly.
- screening can find these aneurysms before they burst.
- screening can be harmful for some people, because it can also find aneurysms that will never cause problems. this may lead to dangerous surgery that isn't really needed.
- people who are at higher risk for aaas will get the most benefit from this test. you are at higher risk if you are a man who is age 65 to 80.
faqs
what is an abdominal aortic aneurysm (aaa)?
an aortic aneurysm (say "a-or-tik an-yuh-rih-zum") is a bulge in part of the aorta, the body's main artery. when this bulge is in the belly (abdomen), it's called an abdominal aortic aneurysm. it's often called "triple a" or "aaa" for short.
these bulges are most common in men older than age 65, people with high blood pressure, and people who smoke. aaas sometimes run in families.
most aortic aneurysms never cause problems, especially if they're small, don't cause symptoms, and don't grow fast.
but if the bulge gets too big, it can burst, or rupture, which is often deadly.
what is the treatment for aaa?
when the bulge is small, not causing symptoms, and not growing fast, it is safe to watch it carefully and wait to have treatment. small aneurysms rarely rupture.
repair of the aneurysm is usually recommended if the aaa is large, causing symptoms, or is growing fast.
there are two ways to repair an aneurysm. one is traditional open surgery. the other is a less invasive procedure called endovascular repair, during which a tube called a stent graft is inserted through an artery in the groin.
what is the screening test for aaa?
screening tests help your doctor look for a certain disease or condition before any symptoms appear. the aaa screening test is an ultrasound test. you lie on a table while a technician does the test. after the test, a radiologist looks at the pictures to see if you have an aneurysm.
aaa screening is fast and painless. it is usually done in the doctor's office or at a hospital.
what are the benefits?
- aaa screening can find large bulges that might rupture if they are not repaired.
- screening can also find smaller bulges that can be watched carefully over the years.
- a study of men ages 65 and older showed that those who have the screening are less likely to die of aaa rupture.footnote 2
what are the risks?
it may seem obvious that aaa screening is good, because it might save your life by finding a bulge before it bursts. the test itself doesn't have risks. but what if you learn during the test that you have a bulge in your aorta? there's no way to know for sure if the bulge will rupture in the future. so you might decide to have surgery or a procedure to fix it. that's where the risks are.
repairing an aaa can be very risky. the benefits outweigh the risks when the aneurysm is at risk of bursting. repair of an aaa can cause problems later, like blood clots or problems with the stent graft in the aorta. and some people die during the operation or soon after.
- with open surgery (the surgeon makes a large cut in the belly and repairs the aorta), about 5 out of 100 people die during surgery or within 30 days.footnote 3 that means about 95 out of 100 people don't die during surgery or within 30 days.
- with an endovascular procedure, in which the surgeon inserts a tube called a stent graft through an artery in the groin, 1 or 2 out of 100 people die within 30 days.footnote 3 that means 98 or 99 out of 100 people don't die within 30 days.
you can see why it's so important to talk to your doctor about whether the benefits of aaa screening outweigh the risks in your case.
why might your doctor recommend screening?
your doctor is likely to recommend screening if you are a man who is age 65 to 80.footnote 1
not all doctors agree on who should be screened for abdominal aortic aneurysm. some say men as young as 50 should be screened if they have a family history. some say women should not be screened at all. talk to your doctor about whether the benefits of screening would outweigh the risks in your case.
talk to your doctor about whether the benefits of screening would outweigh the risks in your case.
compare your options
compare
what is usually involved? | ||
|---|---|---|
what are the benefits? | ||
what are the risks and side effects? |
get screened for aaaget screened for aaa
- you lie on your back on a table for the ultrasound. warmed gel is spread on your belly. then a small hand-held device is pressed against your belly and moved back and forth over it.
- when the ultrasound is done, you may be asked to wait while a doctor looks at the pictures to see if you have an aneurysm.
- the screening usually takes 30 to 60 minutes.
- aaa screening can find a dangerously large aneurysm before it bursts.
- it can also find smaller aaas that can be watched in the future.
- the test results may motivate you to stop smoking.
- the test could lead you to have a risky surgery or procedure to fix an aneurysm that may never have caused trouble.
- you may have a lot of worry if the test finds a large aaa but you can't have it repaired because you have other health problems.
don't get screened for aaadon't get screened for aaa
- if you have an aaa, it might be found during a routine physical exam or during an x-ray, ultrasound, or echocardiogram that's being done for other reasons.
- if you smoke, you could quit smoking to lower your risk of getting an abdominal aortic aneurysm.
- you avoid having to make a decision about whether to have an aneurysm repaired.
- you avoid the worry that might come from learning that you have an aneurysm, even though it may never cause you problems.
- you could have an aneurysm that remains undetected until it ruptures. a rupture is very dangerous.
personal stories about considering aaa screening
these stories are based on information gathered from health professionals and consumers. they may be helpful as you make important health decisions.
i have high blood pressure, and i'm a smoker. i've heard about aaas and how people usually die when they burst. it's pretty scary. i figure it can't hurt to have the test. and i'll just feel better, because either i'll know i don't have an aneurysm or i'll find out i do have one and i can get treatment.
hayden, age 59
my father died when his aneurysm ruptured. so i've been worried about my risk and decided to ask my doctor about it. she explained why this screening probably isn't for me, because even though i have a family history, i'm a woman, and my risk just isn't that high. i'm going to skip this test.
sharon, age 65
i've never been a smoker, but i do have high blood pressure and high cholesterol. so i'm nervous about having an aneurysm that could rupture and maybe kill me. i'm going to ask my doctor if i need to get screened.
jerry, age 68
i smoked in university, but that was decades ago. my doctor says my heart is healthy. if i had the test and they found a small aneurysm, i'd worry about it all the time, probably for no reason. no, thanks! i'm not going to have the test now. maybe in a few years, when my risk is higher.
abed, age 60
what matters most to you?
your personal feelings are just as important as the medical facts. think about what matters most to you in this decision, and show how you feel about the following statements.
where are you leaning now?
now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. show which way you are leaning right now.
what else do you need to make your decision?
check the facts
decide what's next
certainty
3. use the following space to list questions, concerns, and next steps.
your summary
here's a record of your answers. you can use it to talk with your doctor or loved ones about your decision.
your decision
next steps
which way you're leaning
how sure you are
your comments
your knowledge of the facts
key concepts that you understood
key concepts that may need review
getting ready to act
patient choices
credits and references
credits
| author | healthwise staff |
|---|---|
| clinical review board | clinical review board all healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
references
citations
- canadian task force on preventive health care. (2017). recommendations on screening for abdominal aortic aneurysm in primary care. canadian medical association journal, 189(36): e1137–e1145. doi: 10.1503/cmaj.170118. accessed january 3, 2018.
- guirguis-blake jm, et al. (2014). ultrasonography screening for abdominal aortic aneurysms: a systematic evidence review for the u.s. preventive services task force. annals of internal medicine, 160(5): 321–329. doi: 10.7326/m13-1844. accessed august 27, 2014.
- lederle fa, et al. (2007). systematic review: repair of unruptured abdominal aortic aneurysm. annals of internal medicine, 146(10): 735–41. doi: 10.7326/0003-4819-146-10-200705150-00007. accessed december 22, 2016.
you may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
abdominal aortic aneurysm: should i get a screening test?
here's a record of your answers. you can use it to talk with your doctor or loved ones about your decision.
- get the facts
- compare your options
- what matters most to you?
- where are you leaning now?
- what else do you need to make your decision?
1. get the facts
your options
- get a screening test for abdominal aortic aneurysm.
- don't get a screening test.
if you already have symptoms of an abdominal aortic aneurysm and your doctor suspects that you have one, this topic is not for you. your doctor will want you to have the test.
key points to remember
- most abdominal aortic aneurysms, or aaas, never cause problems. but sometimes they burst, which is often deadly.
- screening can find these aneurysms before they burst.
- screening can be harmful for some people, because it can also find aneurysms that will never cause problems. this may lead to dangerous surgery that isn't really needed.
- people who are at higher risk for aaas will get the most benefit from this test. you are at higher risk if you are a man who is age 65 to 80.
faqs
what is an abdominal aortic aneurysm (aaa)?
an aortic aneurysm (say "a-or-tik an-yuh-rih-zum") is a bulge in part of the aorta, the body's main artery. when this bulge is in the belly (abdomen), it's called an abdominal aortic aneurysm. it's often called "triple a" or "aaa" for short.
these bulges are most common in men older than age 65, people with high blood pressure, and people who smoke. aaas sometimes run in families.
most aortic aneurysms never cause problems, especially if they're small, don't cause symptoms, and don't grow fast.
but if the bulge gets too big, it can burst, or rupture, which is often deadly.
what is the treatment for aaa?
when the bulge is small, not causing symptoms, and not growing fast, it is safe to watch it carefully and wait to have treatment. small aneurysms rarely rupture.
repair of the aneurysm is usually recommended if the aaa is large, causing symptoms, or is growing fast.
there are two ways to repair an aneurysm. one is traditional open surgery. the other is a less invasive procedure called endovascular repair, during which a tube called a stent graft is inserted through an artery in the groin.
what is the screening test for aaa?
screening tests help your doctor look for a certain disease or condition before any symptoms appear. the aaa screening test is an ultrasound test. you lie on a table while a technician does the test. after the test, a radiologist looks at the pictures to see if you have an aneurysm.
aaa screening is fast and painless. it is usually done in the doctor's office or at a hospital.
what are the benefits?
- aaa screening can find large bulges that might rupture if they are not repaired.
- screening can also find smaller bulges that can be watched carefully over the years.
- a study of men ages 65 and older showed that those who have the screening are less likely to die of aaa rupture.2
what are the risks?
it may seem obvious that aaa screening is good, because it might save your life by finding a bulge before it bursts. the test itself doesn't have risks. but what if you learn during the test that you have a bulge in your aorta? there's no way to know for sure if the bulge will rupture in the future. so you might decide to have surgery or a procedure to fix it. that's where the risks are.
repairing an aaa can be very risky. the benefits outweigh the risks when the aneurysm is at risk of bursting. repair of an aaa can cause problems later, like blood clots or problems with the stent graft in the aorta. and some people die during the operation or soon after.
- with open surgery (the surgeon makes a large cut in the belly and repairs the aorta), about 5 out of 100 people die during surgery or within 30 days.3 that means about 95 out of 100 people don't die during surgery or within 30 days.
- with an endovascular procedure, in which the surgeon inserts a tube called a stent graft through an artery in the groin, 1 or 2 out of 100 people die within 30 days.3 that means 98 or 99 out of 100 people don't die within 30 days.
you can see why it's so important to talk to your doctor about whether the benefits of aaa screening outweigh the risks in your case.
why might your doctor recommend screening?
your doctor is likely to recommend screening if you are a man who is age 65 to 80.1
not all doctors agree on who should be screened for abdominal aortic aneurysm. some say men as young as 50 should be screened if they have a family history. some say women should not be screened at all. talk to your doctor about whether the benefits of screening would outweigh the risks in your case.
talk to your doctor about whether the benefits of screening would outweigh the risks in your case.
2. compare your options
| get screened for aaa | don't get screened for aaa | |
|---|---|---|
| what is usually involved? |
|
|
| what are the benefits? |
|
|
| what are the risks and side effects? |
|
|
personal stories
personal stories about considering aaa screening
these stories are based on information gathered from health professionals and consumers. they may be helpful as you make important health decisions.
"i have high blood pressure, and i'm a smoker. i've heard about aaas and how people usually die when they burst. it's pretty scary. i figure it can't hurt to have the test. and i'll just feel better, because either i'll know i don't have an aneurysm or i'll find out i do have one and i can get treatment."
— hayden, age 59
"my father died when his aneurysm ruptured. so i've been worried about my risk and decided to ask my doctor about it. she explained why this screening probably isn't for me, because even though i have a family history, i'm a woman, and my risk just isn't that high. i'm going to skip this test."
— sharon, age 65
"i've never been a smoker, but i do have high blood pressure and high cholesterol. so i'm nervous about having an aneurysm that could rupture and maybe kill me. i'm going to ask my doctor if i need to get screened."
— jerry, age 68
"i smoked in university, but that was decades ago. my doctor says my heart is healthy. if i had the test and they found a small aneurysm, i'd worry about it all the time, probably for no reason. no, thanks! i'm not going to have the test now. maybe in a few years, when my risk is higher."
— abed, age 60
3. what matters most to you?
your personal feelings are just as important as the medical facts. think about what matters most to you in this decision, and show how you feel about the following statements.
4. where are you leaning now?
now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. show which way you are leaning right now.
5. what else do you need to make your decision?
check the facts
1. does aaa screening help prevent death from ruptured aneurysms?
- yes
- no
- i'm not sure
that's right. screening can find aaas before they rupture, and a ruptured aneurysm is often deadly.
2. can aaa screening be harmful?
- yes
- no
- i'm not sure
that's right. although the test itself is harmless, it could lead you to have risky surgery on an aneurysm that may never have caused a problem.
3. which group is most likely to get aaas?
- women
- men age 45 to 60
- men older than age 65.
- i'm not sure
you're right. these aneurysms are most common in men older than age 65, people with high blood pressure, and people who smoke.
decide what's next
1. do you understand the options available to you?
2. are you clear about which benefits and side effects matter most to you?
3. do you have enough support and advice from others to make a choice?
certainty
2. check what you need to do before you make this decision.
- i'm ready to take action.
- i want to discuss the options with others.
- i want to learn more about my options.
3. use the following space to list questions, concerns, and next steps.
credits
| by | healthwise staff |
|---|---|
| clinical review board | clinical review board all healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
references
citations
- canadian task force on preventive health care. (2017). recommendations on screening for abdominal aortic aneurysm in primary care. canadian medical association journal, 189(36): e1137–e1145. doi: 10.1503/cmaj.170118. accessed january 3, 2018.
- guirguis-blake jm, et al. (2014). ultrasonography screening for abdominal aortic aneurysms: a systematic evidence review for the u.s. preventive services task force. annals of internal medicine, 160(5): 321–329. doi: 10.7326/m13-1844. accessed august 27, 2014.
- lederle fa, et al. (2007). systematic review: repair of unruptured abdominal aortic aneurysm. annals of internal medicine, 146(10): 735–41. doi: 10.7326/0003-4819-146-10-200705150-00007. accessed december 22, 2016.
note: the "printer friendly" document will not contain all the information available in the online document some information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
current as of: august 6, 2023
author: healthwise staff
clinical review board
all healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
