Sep 19 (HeartCenterOnline) - Researchers have determined that screening for abdominal aortic aneurysms is both accurate and cost-effective. The study is published in the September 2002 issue of the journal Surgery.

An aortic aneurysm is the dilation, bulging or ballooning out of part of the wall of the aorta, the artery through which blood flows out of the heart to the body. An aneurysm develops where the wall of the aorta has weakened, often due to atherosclerosis ("hardening of the arteries"), high blood pressure (hypertension), Marfan syndrome, or chronic infections such as syphilis or tuberculosis.

Basically, there are two types of aortic aneurysms, classified according to where they are located along the aorta. A thoracic aortic aneurysm is located somewhere along the segment of aorta that passes through the chest (thorax), and the abdominal aortic aneurysm is located somewhere along the segment of aorta that travels through the abdomen. Abdominal aortic aneurysms (AAAs) can also run in families.

The majority of aortic aneurysms cause no symptoms at all. While still small, these aortic aneurysms may be monitored by controlling high blood pressure, especially with medications called beta blockers. However, larger aortic aneurysms may require surgery to prevent the aortic aneurysm from rupturing (a potentially fatal event).

According the American Heart Association's 2001 Heart and Stroke Statistical Update, aortic aneurysms are responsible for more than 16,000 deaths annually in the United States. The researchers addressed the fact that most individuals do not survive a ruptured aneurysm and, moreover, die before being able to receive medical treatment. It was felt that such statistics could be improved. They wanted to demonstrate that ultrasound screening for AAAs could (and should) be a routine examination, one that is high in accuracy and low in cost. In so doing, at-risk individuals could be identified and treated.

The study consisted of 25 patients having either a family history of AAA, or three or more of the following risk factors for AAA:

* Greater than 60 years of age
* Current or former smoker
* Hypertension
* High cholesterol
* Heart disease
* History of leg bypass surgery (peripheral bypass surgery)
* Difficulty walking or symptoms due to poor leg circulation
* Carotid artery disease
* Stroke

All the patients were given a standard abdominal duplex ultrasound; this takes about 24 minutes to perform. But the researchers also had the patients undergo a "Quick Screen" ultrasound lasting less than five minutes. Aneurysms were detected in seven patients with both ultrasound strategies. Demonstrating such accuracy in a much shorter period of time translates into a lower cost for the procedure. As a result, the researchers state that the Quick Screen deserves to be covered by Medicare and insurance companies. If so, according to Dr. K. Craig Kent and colleagues at the New York-Presbyterian Hospital-Weill Cornell Medical College, it could mean "a significant change in routine care for older men and women - and many extended lives."

For additional information on this topic visit HeartCenterOnline's Aneurysm Center.

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