Radiological screening of people over 65 for abdominal aortic aneurysm

Purpose: Abdominal aortic aneursyms (AAA), while usually asymptomatic, can lead to aneurysm rupture, its most important complication. The primary purpose of treatment is to prevent rupture. Following rupture, the mortality rate of AAA is quite high, with post-rupture death rate reaching 80%, and the patients that manage to reach a hospital still having a death rate of 50%, despite emergency operation. The most important method for prevention of rupture related to AAA is elective surgery or repair, and the detection of the patients to be referred for treatment is an important consideration. For this to be a cost effective method, screening of chosen individuals with risk factors is important. The purpose of our study is, determining the frequency of AAA and its risk factors in patients applying to the US unit, and evaluating in US examination. Material and Methods: A total of 600 patients between ages 65-100 (average age; 71,69), with 335 being male (average age; 71,52) and 265 being female (average age; 71,88) were included in the study. In this work, we studied the prevalence of AAA and its association with atherosclerotic risk factors in patients over the age of 65, with US and Doppler US. The greatest diameter of abdominal aorta was measured from outer wall to outer wall. Presence of a thrombus and the patent luminal diameter was evaluated. In patients with thrombosed parts, in determination of patent lumen or in patients with suspected rupture, CDUS was used for evaluation. Findings: Out of a total of 600 patients, 35, corresponding to 5.8% of the screened population, were diagnosed AAA. 33 of these were male, making up 94% of diagnosed patients and 5.5% of the screened population. The remaining 2 were female, making up 6% of diagnosed patients and 0.3% of the total screened population. There was statistically significant correlation between being male and increased risk of AAA (p<0.05). 5.6% of the patients between ages of 65-79, and 7% over the age of 80 were diagnosed with AAA. AAA prevalence increases with age, history of smoking or having CAD. Discussion-Conclusion: Since the prevalence of AAA is high in people over the age of 65 with atherosclerotic risk factors, it is important to screen this population for AAA and treating those with detected AAA to prevent possible rupture. US, being non-invasive and performable at bedside, without requiring contrast agents or exposing the patient to radiation, and being able to determine the location, level and possible thrombosed components of AAA rapidly and with high accuracy is an efficient and safe method for screening of high risk populations. Radiology clinics have an important part in diagnosis and treatment of all atherosclerotic diseases with use of ultrasound, computerized tomography, magnetic resonance imaging and interventional radiology; and can also play a major role in early diagnosis with radiological screening programs Key words: Abdominal aortic aneurysm, risk factors, population screening, Doppler US.