Expanding Current AAA Screening Recommendations Could Identify More Patients with AAA

The U.S. Preventive Services Task Force (USPSTF) guidelines are the most widely used criteria for screening for abdominal aortic aneurysms (AAA). The current USPSTF guidelines recommend a one-time abdominal ultrasound in men 65 to 70 years of age with a history of smoking. Criteria from the Society for Vascular Surgery (SVS) is also used, and it recommends a one-time abdominal ultrasound in men and women aged 65 to 75 years with a smoking history. The SVS expanded criteria to include an abdominal screening ultrasound in those aged ≥ 65 years with a family history of AAA (first-degree relative) and those > 75 years with a smoking history.  

Patients who underwent elective, urgent, and emergent open AAA repair and endovascular aneurysm repair (EVAR) were identified using the SVS Vascular Quality Initiative (VQI) data set. A retrospective analysis of this group was performed using the current USPSTF and SVS criteria and it was determined that many of the patients did not meet any the current screening criteria. However, when the SVS expanded criteria was applied to the same group of patients, more patients were identified as meeting the screening criteria. The key findings are as follows:

  • Fewer than one-third of patients would have been identified using USPSTF criteria (32% EVAR and 33% open repair).
  • With the addition of SVS and expanded SVS criteria, the rate of patients identified increased by 6% and 34% for EVAR, respectively, and 12% and 33% for open repair, respectively.
  • 28% of patients who underwent AAA repair did not meet any screening criteria.
  • In patients who did not meet any screening criteria, 93% of patients aged < 65 years had a history of smoking, whereas smoking history was nonexistent in those aged > 65 years.
  • Ruptured AAA was twice as prevalent in patients who did not meet any screening criteria as compared with those who did (8.5% vs 4.4%; P ≤ .001).

To read the article in its entirety, click here:

https://evtoday.com/news/expanding-current-aaa-screening-recommendations-could-identify-a-greater-number-of-patients-with-aaa?utm_campaign=EVT%20news&utm_medium=email&_hsmi=103845485&_hsenc=p2ANqtz-_Xrh91hY8F7CVa9pQ4bf-xZvNzziHG5qxH7HHYgQg9RD7tdOvdFGGjYRiK-WnK2Mdb7mPYdIe64k4FrPut0Sd3L8RIvQcwsqBhsnqmVaW5cnWjmzg&utm_content=103845485&utm_source=hs_email

To review the clinical abstract in its entirety, click here:

https://www.jvascsurg.org/article/S0741-5214(20)30601-7/abstract