Screening and surveillance for abdominal aortic aneurysms: who needs it and when.

Early detection of abdominal aortic aneurysms potentially can save many lives by preventing aneurysm rupture. Screening programs, however, have yet to be proven as an efficient means of accomplishing this goal and improving overall life expectancy. Until more information is available, selective high-risk screening may be the only viable option. Recently, 2 large prospective studies have better defined the utility of screening programs and have provided guidelines for the safe nonoperative management of small aneurysms. Using ultrasound surveillance, these can be followed up at 3- to 12-month intervals, depending on their size, with operative intervention reserved for aneurysms that enlarge rapidly, become symptomatic, or reach 5.5 cm in diameter.
(Copyright 2001 by W.B. Saunders Company)