The NHS Abdominal Aortic Aneurysm (AAA) screening programme has been introduced across England and the Implementation began in March 2009. University Hospitals of Leicester (UHL) was one of the first six pioneer Institutions in the country to implement screening for abdominal aortic aneurysm. Prior to becoming a part of the national programme between 1996 and 2009 the UHL offered a voluntary ‘opt’ in screening programme for the GP practices which achieved approximately 40% coverage of the Leicester, Leicestershire and Rutland area.
With the implementation of the National Screening Programme in 2009, this has now been extended to cover all GP surgeries across Leicester, Leicestershire and Rutland. The screening test is very quick, painless and reliable.
What is an Abdominal Aortic Aneurysm? Abdominal aortic aneurysm is a balloon - like swelling of the aorta, the main artery leading away from your heart which passes through your abdomen. It can be serious if it is not spotted early on because it could get bigger and eventually burst (rupture).
Prevalence:
a. Around 1 in 92 men aged 65 in England has an AAA. .
b. Around 3,000 deaths each year in men aged 65 and over in England and Wales from ruptured AAA .
c. Deaths from ruptured AAA account for 1.7% of all deaths in men aged 65 and over.
What are the Symptoms of having an AAA?
Abdominal aortic aneurysms often grow slowly without symptoms, making them difficult to detect. This is why the AAA screening programme was introduced, following research, which showed it could reduce the rate of premature death from ruptured AAA by 50% by detecting and treating large aneurysms before they burst. Around 1 in 92 men who are screened have an AAA.
Diagnosis:
A simple ultrasound scan is performed to detect an AAA.
985 in 1000 men who are screened have normal results
14 in 1000 men are found with smaller to medium aneurysm
1 in 1000 men had large aneurysm( Aortic diameter 5.5cm or above)
Early detection When an aneurysm is detected early, treatment is safe and effective and the aneurysm is curable.
Who is at risk?
People at a higher risk of getting an AAA include:
a. Men are six times more likely to develop an aneurysm than a woman. The chance of having an aneurysm increases with age. Two out of every three deaths from ruptured AAA in England and Wales occur in men who are over 65.
b. people who smoke – if you smoke or used to smoke, you're up to 15 times more likely to get an AAA
c. people with high blood pressure – high blood pressure can double your risk of getting an AAA
d. people with a parent, sibling or child with an AAA – you're about four times more likely to get an AAA if a close relative has had one
Results of AAA screening:
Immediately after the scan, men will be informed of the result of the test by the screening practitioner.
Negative result
Men will not be asked to return to have another scan and will be discharged from the screening programme.
Positive result
If an AAA is detected , the patient pathway and the implications of the diagnosis are fully explained to men in a clear, concise and sensitive way. General Practitioners will be informed of the outcome of all positive AAA scans.
What happens next?
Small AAA:
• Men found to have an AAA less than 4.5 cm in diameter will be asked to attend for yearly follow-up scans to monitor any increase in size.Just over 1% of men screened have a small AAA.
Read a leaflet on small AAA (PDF, 2.3Mb) for more information.
Medium AAA:
• Men found to have an AAA between 4.5 cm and 5.4 cm will be asked to attend for follow up scans every three months.About 0.5% of men screened have a medium AAA.
Read a leaflet on medium AAA (PDF, 2.3Mb) for more information.
Large AAA:
• Men found to have an AAA greater than 5.4 cm will be referred by the programme to a local vascular service for assessment. 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.
Steps patients can take which may slow down the growth of an AAA?
a. stopping smoking – read stop smoking advice and find out about Smokefree,, the NHS stop smoking service
b. eating healthily – eat a balanced diet and cut down on fatty food
c. exercising regularly – at least 150 minutes of exercise a week; read about how to get started with some common activities
d. maintaining a healthy weight – use the healthy weight calculator to see if you might need to lose weight, and find out how to lose weight safely
e. cutting down on alcohol – read some tips on cutting down and general advice about alcohol
f. make sure your blood pressure is normal, if you have not had it checked it recently, it is worth getting it checked.
g. If you have a high blood pressure , your GP may also recommend taking tablets to treat this.
Ruptured AAA Symptoms:
If your aortic aneurysm ruptures, you will 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. Around 85 out of 100 people with a rupture AAA die before they reach hospital or don’t survive emergency surgery.
To help you decide if you should be screened you can visit the AAA screening patient Decision Aid at Abdominal aortic aneurysm screening: short form decision aid
Self-Referral:
(Leicester, Leicestershire & Rutland) Men who are older than 65 years, and never been screened or treated for an abdominal aortic aneurysm, can self-refer by contacting the screening office on 0116 258 6820
This leaflet provides information about abdominal aortic aneurysm screening (also called AAA screening) for men who have been invited for screening by the National Screening Programme.
Can access AAA leaflets in many languages from below given link: https://www.gov.uk/government/publications/abdominal-aortic-aneurysm-screening-invitation-leaflet
More Information:
https://www.circulationfoundation.org.uk/patient_info/abdominal-aortic-aneurysm/
