Thoughts on the Frequency of Scans for Small Aortic Aneurysms

Frank J. Criado, MD, FACS, FSVM, editor in chief of Vascular Disease Management

Frank J. Criado, MD, FACS, FSVM, editor in chief of Vascular Disease Management

In the editorial for the April issue of Vascular Disease Management, Dr. Criado discusses new data on the efficacy of frequent screenings for small abdominal aortic aneurysms (AAA). Traditional monitoring of small AAAs, which are aneurysms of less than 5.5 cm in diameter, has been ultrasound or computed tomography every 6 months or more frequently. But the authors of the UK-based RESCAN study estimated based on their results that controlling the risk of aneurysm rupture in men to under 1% would require surveillance intervals of only 8.5 years for 3-cm aneurysms and 17 months for 5-cm aneurysms.

“There is no doubt that decreasing surveillance frequency would lead to decreased costs and savings and fewer unnecessary scans. However, it could also increase patients’ anxiety and nervousness and potentially compromise the quality of their lives,” says Dr. Criado. A sampling of discussion among patients about surveillance scans for AAA on the Vascular Disease Foundation Support community discussion board reinforces his point about patient anxiety.

Nonetheless, reducing costs and reducing unnecessary procedures is of great importance. And “in the end, it seems almost certain that current small-aneurysm surveillance practices are off-base and unnecessarily frequent – and particularly so in the United States,” Dr. Criado adds. “It is time to re-examine.”

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