How are most abdominal aortic aneurysm detected, and what is the role of screening?
Symptomatic aneurysms manifest with back, abdominal, buttock, groin, testicular, or leg pain. Most AAAs are asymptomatic, however. AAAs can be easily detected via ultrasonography (US), which has been shown to be cost-effective in targeted, high-risk patients. If AAA ruptures, the mortality rate is greater than 85%, and the morbidity rate and cost are significant for patients who survive. Elective repair of aneurysms is associated with low rates of mortality and morbidity, so aneurysmal disease is well suited to screening. Many hospitals and private, mobile screening companies offer aneurysm screening, often in conjunction with screening for other conditions such as peripheral and carotid arterial disease. The U.S. Congress passed the SAAAVE Act (Screen Abdominal Aortic Aneurysms Very Efficiently) in late 2005. Medicare-funded AAA screening is limited to male ever-smokers and to men and women with a positive family history of AAA.