Abdominal aortic aneurysm (AAA)

An abdominal aortic aneurysm (AAA) is a weakening and expansion of the aorta, the main blood vessel in the body. Large aneurysms are rare but can be very serious.

COVID-19 Update:

Abdominal aortic aneurysm (AAA) screening appointments have now started to resume. We have made several changes in line with national guidance and we will be offering reduced clinics until further notice. Thank you for your understanding at this difficult time. If you require any further information, please do not hesitate to contact us on 01205 445801.

Abdominal aortic aneurysm (AAA)

The NHS Abdominal aortic aneurysm (AAA) screening programme was introduced across England and the implementation began in March 2009. Lincolnshire was one of the latest areas to start screening in 2012/13. The screening test is very quick, painless and reliable.

What is an abdominal aortic aneurysm (AAA)?

An abdominal aortic aneurysm (AAA) is a bulge or swelling in the aorta, the main blood vessel that runs from the heart down through the chest and abdomen (tummy). It can be serious if it is not spotted early, as the AAA could get bigger and eventually burst (rupture). AAAs often grow slowly often without any symptoms, making them difficult to detect without diagnostic imaging (this scan).

Prevalence:

  • Around 1 in 92 men aged 65 in England has an AAA
  • Around 3,000 deaths each year in men aged 65 and over in England and Wales from ruptured AAA
  • Deaths from ruptured AAA account for 1.7% of all deaths in men aged 65 and over

Who is invited for AAA screening?

AAA screening is offered to men during the screening year (1 April to 31 March) that they turn 65. Men aged 65 and over are most at risk of AAAs, and screening can help spot a swelling in the aorta at an early stage. Men are six times more likely than women to suffer from an AAA. 95% of ruptured AAA’s occur in men aged 65 and over.

Men who are a resident in England receive an invitation in the post for screening when they are aged 64 or 65. However, men over the age of 65 who have not yet been seen are welcome to self-refer for an appointment by contacting the office on 01205 445801 or emailing us via ulh-tr.AAAScreening@nhs.net

Who is excluded?

  • Women
  • Men under 64-65
  • Men who have had a normal result already
  • Men who have already had an AAA repair
  • Any man who is under surveillance elsewhere for an AAA
  • Any man who has requested to be permanently removed from the programme

Any women, or men under 65 who think they are at higher risk (for example, due to family history of the condition) can talk to their GP about the possibility of having a scan outside the screening programme.

Risk factors:

The chances of having an AAA can increase if:

  • Men over 65
  • You have smoked or still smoke
  • High blood pressure
  • Family history of AAA
  • High cholesterol
  • Very little physical activity
  • Overweight or a BMI over 40

Where is screening carried out in Lincolnshire?

AAA screening is carried out at numerous venues across Lincolnshire;

Hospital sites: Pilgrim Hospital, New Johnson Community Hospital, Grantham Hospital, Louth County Hospital, Skegness Hospital, John Coupland Hospital.

GP Surgeries: Market Deeping Surgery, Nettleham Medical Centre.

What does screening involve?

The AAA screening test is a quick and painless simple ultrasound scan of the abdomen (tummy). It is similar to the scan pregnant women have to check on their baby.

For the scan:

  1. The man lies down on a table and lifts up or unbuttons his top (he does not need to undress).
  2. The scanning technician puts a clear gel on the tummy and moves a small handheld scanner over the skin – pictures from the scanner are shown on a monitor and the technician measures how wide the aorta is.
  3. The man wipes away the gel and pulls down or buttons up their top.
  4. The technician tells the man his screening result straight away.

The whole test usually takes about 10 to 15 minutes.

There are four AAA screening results. These are:

  • No aneurysm found (<2.9cm) Men will not be asked to return to have another scan and will be discharged from the screening programme.
  • Small AAA (3.0cm – 4.4cm) – Annual Surveillance required. Nationally – Just over 1% of men screened have a small AAA. Read a leaflet on small AAA (PDF, 2.3Mb) for more information.
  • Medium AAA (4.5cm – 5.4cm) – 3 monthly Surveillance required. Nationally – About 0.5% of men screened have a medium AAA. Read a leaflet on medium AAA (PDF, 2.3Mb) for more information.
  • Large AAA (>5.5cm) – Referral to Consultant Surgeon. Nationally, about 0.1% of men screened have a large AAA. As large AAAs  are at the highest risk of bursting if left untreated, you’ll be referred to a specialist surgeon within 2 weeks to talk about your treatment options. Most men with a large AAA are advised to have surgery to stop it getting bigger or bursting.

Read a leaflet on large AAA (PDF, 2.2Mb) for more information and read about how a large AAA is treated.

You can read more on the NHS website about what each result means, and what will happen next.

Why is AAA screening so important?

AAA screening is important because often the patient will not notice any symptoms if they have an aneurysm, but if it’s left to get bigger, it could burst and cause life-threatening bleeding inside your tummy.

Screening can pick up an AAA before it bursts. If an AAA is found, you can choose to have regular scans to monitor it or planned surgery to stop it bursting. Around 85 out of 100 people with a rupture AAA die before they reach hospital or don’t survive emergency surgery.The screening test is non-invasive, very quick, painless and reliable. Research suggests it can halve the risk of dying from an AAA.

Ruptured AAA symptoms:

If your aortic aneurysm ruptures, you may feel a sudden and severe abdominal pain and/or Lower back pain.

It is a medical emergency and seek help through accident and emergency by calling 999.

Other symptoms include: dizziness sweaty and clammy skin rapid heartbeat (tachycardia) shortness of breath feeling faint. Loss of consciousness.

Deciding to be screened:

It’s up to you to decide if you want to be screened for AAA.

While there are clear benefits of screening, you should also consider the possible risks. There’s no risk from the screening test itself, but there’s a risk of:

  • Anxiety from being told you have a life-threatening condition
  • Serious complications of surgery carried out to treat an AAA

You’ll get a leaflet with your screening invitation to help you make a decision.

You can also read a decision aid leaflet online.

Please call the local screening office (01205 445801) and ask to be removed from its list if you do not want to be screened.

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