What is classed as an AAA?
The National AAA Screening Programme guidance is that we class the aortic measurements as follows:
3.0cm to 4.4cm = Small AAA
4.5cm to 5.4cm = Medium AAA
5.5cm+ = Large AAA
What happens if I have a small AAA?
If you have a small AAA detected, you will receive this information booklet from the screening technicians. You will then automatically be entered into our annual surveillance programme so we can monitor the AAA on a regular basis. You will also be offered an appointment to see one of our vascular nurse specialists either at the LGI or at Pinderfields Hospital where they will receive further information and health improvement advice aimed at reducing the future risk of cardiovascular events. Your GP will also be kept informed of the result.
What happens if I have a medium AAA?
If you have a medium AAA detected, you will receive this information booklet from the screening technicians. You will then automatically be entered in to our 3 monthly surveillance programme so we can monitor the AAA on a more frequent basis. You will also be offered a further appointment to see one of our vascular nurse specialists either at the LGI or at Pinderfields Hospital where they will receive further information and health improvement advice aimed at reducing the future risk of cardiovascular events. Your GP will also be kept informed of the result.
What happens if I have a large AAA?
If you have a large AAA detected, you are immediately referred on to the vascular surgery team at the LGI and an outpatient consultation to see a consultant vascular surgeon within 7 working days will be offered. You will also be given this information booklet by the screening technicians. Your GP will also be made aware that the referral process to a consultant vascular surgeon has commenced. Your GP will be asked for any additional clinical information that they may feel is relevant. At the appointment with the consultant vascular surgeon, you will be advised as to the treatment options available (depending on fitness and suitability). Further tests will also be arranged to measure heart and lung function and provide further information on the shape of the aneurysm. The results of these tests are then used to plan the best treatment for you.
Will I need an operation?
Once a AAA has reached 5.5cms then the consultant vascular surgeon and their team will consider possible surgical intervention. There are two types of operations that can be done to repair an aneurysm:
Open surgery: this involves an incision in the abdomen and replacement of the affected section of blood vessel with a synthetic tube.
Endovascular (EVAR) surgery: this is a form of keyhole surgery using a stent graft to reline the dilated aorta.
If your surgeon recommends an operation, they will give you more information
Why do I need to have my aneurysm checked regularly?
The larger your aneurysm becomes the more chance there is of it causing serious problems. Most abdominal aortic aneurysms occur in the lower end of the aorta. In this position they can get bigger without causing any symptoms. Most aneurysms grow slowly at a rate of about 3mm (1/8 inch) per year. However, larger aneurysms can grow more quickly so scans are done more frequently.
What is the chance of a small AAA rupturing?
The chance of rupture is very low for a small AAA. For aneurysms measuring less than 5.5cm in diameter the risk of rupture is less than one in 100 per year. As aneurysms get larger than 5.5cm, the risk of rupture increases, and it is usually at this size surgery is considered. For any given size, rupture risk is increased in smokers, those with high blood pressure, and those with a family history of an AAA.
Each individual’s risk from their AAA and from surgery may be different so any decision on treatment will be carefully considered by the vascular team and always discussed in detail with you and, when appropriate, your family.
How can I look after my health?
Here are some things you can do:
- If you are a smoker, seek help to try to cut down or stop.
- Make sure your blood pressure is normal. If you have not had it checked recently, it is worth getting it checked.
- Eat a healthy, balanced diet and cut down on fatty food.
- If you are overweight, try to lose weight
- Take regular exercise.
- If you drink alcohol, keep within sensible limits.
You do not need to make any other changes to your lifestyle and should continue with any sports or hobbies. Your GP practice will be able to give you advice on all of the above and may also want to give you medication or review your current medication.
What about close family?
The risk of having an AAA increases if your brother, sister or parent has, or has had, an abdominal aortic aneurysm. You should therefore inform any brothers, sisters, or children that your AAA means that they are also at risk. They can ask their GP about the possibility of requesting a scan at an age five years earlier than the age at which your AAA was found.
Will I feel unwell?
If you have an aneurysm, you will not generally notice any symptoms, so it is unlikely that you will feel any pain or discomfort from a large aneurysm. If you go into hospital for any reason, you should let the staff know that you have an abdominal aortic aneurysm found through screening.
If you have questions about your screening result, you can phone your local screening programme on 0113 2063640. If you feel generally unwell, you should speak to your GP.
What are the symptoms of a burst aneurysm?
If you have new symptoms of severe, persistent abdominal and/or lower back pain, you should seek immediate medical help through an accident and emergency department. Make sure you tell any medical staff that you have an AAA.
If you have questions about your test result, you can phone your local screening programme. If you feel generally unwell, you should speak to your GP.
What about driving?
Car drivers: You must inform the DVLA if your aneurysm grows to 6cm. Your licence will be suspended if your aneurysm grows to 6.5cm. Your licence will be reinstated after your aneurysm has been successfully treated.
Bus, coach and lorry drivers: You must inform the DVLA that you have an aneurysm. Your licence will be suspended if your aneurysm is 5.5+cm. Your licence will be reinstated after your aneurysm has been successfully treated.
What about health-related insurance?
If you declare your AAA when applying for travel or any other health-related insurance, you may be charged an additional premium or have the condition excluded from cover. When looking for cover, a broker can help.
More Information
- National AAA Screening Website
- National AAA Screening Programme Office Number: 020 3682 0890
- Vascular Society website
- NHS Choices – Abdominal Aortic Aneurysms
- AAA Screening Supporting Documents
- Circulation Foundation
- British Heart Foundation
- Your local screening programme on 0113 2063640 and our email is [email protected]