What is an abdominal aortic aneurysm (AAA)?

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The aorta is the largest blood vessel in the body, carrying blood from the heart into the abdomen and lower extremities. It normally measures 2-2.5 cm in healthy adults. 

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An abdominal aortic aneurysm (AAA) is when the abdominal section of the aorta expands to over 3 cm, roughly 1.5 to 2 times its normal size. Intervention is often considered when an AAA reaches 5.5 cm in men and 5 cm in women.

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Why and how do we screen? 

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Physical exams alone are usually ineffective for detecting AAAs, so many cases are missed or only found by chance during imaging for other issues.

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Most AAAs are asymptomatic until they are about to or have already ruptured, and a ruptured AAA is often fatal. 

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Screening is done with an abdominal ultrasound. This is quick, non-invasive and no radiation exposure. 

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Who do we screen?

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Canadian, American, and international guidelines generally agree on recommendations for men but differ somewhat for women. Men aged 65–80 are generally advised to have a one-time abdominal ultrasound for AAA screening.

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Starting in June 2025, women aged 65+ will be eligible for screening as well. Women were mostly excluded from major AAA screening studies, but recent Ontario research shows screening is cost-effective for women. Screening is recommended for women aged 65-80, especially those who smoke, have a family history of AAA, or a history of cardiovascular disease.

 

Risk factors for AAA:

- Smoking

- Male sex

- Age

- Hypertension

- Dyslipidemia

- Family History

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