The management of ruptured abdominal aortic aneurysms: screening for abdominal aortic aneurysm and incidence of rupture

Von Allmen, R S; Powell, J T (2012). The management of ruptured abdominal aortic aneurysms: screening for abdominal aortic aneurysm and incidence of rupture. Journal of cardiovascular surgery, 53(1), pp. 69-76. Torino: Minerva Medica

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Twenty-five years have passed since the first randomised controlled trial began its recruitment for screening for abdominal aortic aneurysm (AAA) in men aged 65 and above. Since this and other randomised trials, all launched in the late 80s and 90s of the last century, the epidemiologic profile of abdominal aortic aneurysm may have changed. The trials reported an AAA prevalence in the range of 4-7% for men aged 65 years or more. AAA-related mortality was significantly improved by screening, and after 13 years, the largest trial showed a benefit for all-cause mortality. Screening also was shown to be cost-effective. Today, there are studies showing a substantial decrease of AAA prevalence to sometimes less than 2% in men aged ≥ 65 years and there is evidence that the incidence of ruptured aneurysm and mortality from AAA is also declining. This decline preceded the implementation of screening programmes but may be due to a change in risk factor management. The prevalence of smoking has decreased and there has been improvement in the control of hypertension and a rising use of statins for cardiovascular risk prevention. Additionally, there is a shift of the burden to the older age group of ≥ 75 years. Such radical changes may influence screening policy and it is worth reflecting on the optimum age of screening - it might be better to screen at ages >65 years - or rescreening 5 to 10 years after the first screen.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

von Allmen, Regula

ISSN:

0021-9509

Publisher:

Minerva Medica

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:37

Last Modified:

17 Mar 2015 21:27

PubMed ID:

22231532

Web of Science ID:

000301270600010

URI:

https://boris.unibe.ch/id/eprint/14757 (FactScience: 221870)

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