Abdominal aortic aneurysm

Question 1

What is an abdominal aortic aneurysm?

Answer 1

Dilation of the abdominal aorta, with a diameter of more than 3cm

Question 2

Where does a AAA most commonly form?

Answer 2

Below the level of the renal arteries - called an infra-renal anerysm

Question 3

What are the risk factors for AAA?

Answer 3

Increasing age
Male gender
Smoking
Hypertension
Connective tissues disorders - Elhers Danlos and Marfan syndrome
Family history

Question 4

Who is offered screening for AAA?

Answer 4

All men in England are offered a screening ultrasound at age 65 to detect asymptomatic AAA

Question 5

What is the presentation of AAA?

Answer 5

Most cases are asymptomatic
Symptoms can include:
- Flank, back or abdominal pain
- Pulsating abdominal sensation

Question 6

What is the initial investigation for diagnosis of a AAA?

Answer 6

Abdominal ultrasound

Question 7

What other investigations may be considered in diagnosis of AAA?

Answer 7

FBC - leaking AAA can cause anaemia
U&Es
CRP/ESR
Group and save and crossmatch
CT angiogram - more detailed anatomical information

Question 8

How often should identified AAA be rescanned?

Answer 8

3-4.4cm - rescan every 12 months
4.5-5.4cm - rescan every 3 months
>5.5cm - refer within 2 weeks to vascular surgery

Question 9

What are the indications for elective repair of aneurysm?

Answer 9

Symptomatic aneurysm
Diameter growing more than 1cm per year
Diameter above 5.5cm