Home » Patients Who Should be Screened for Abdominal Aortic Aneurysm

Patients Who Should be Screened for Abdominal Aortic Aneurysm

An Abdominal Aortic Aneurysm (AAA) develops in the section of the aorta located in the abdomen that supplies blood to the lower part of the body. An AAA can be categorized as small, 3.0-3.9 cm in width, medium, 4.0-5.4 cm, or large at more than 5.4 cm. Large AAAs are the most dangerous due to the potential for rupture and are usually treated with surgery or endovascular repair. AAA can continue to grow, so even if categorized as small and medium, they need to be periodically monitored to determine the rate of growth.

Who is at Risk?
According to Medscape, 15,000 deaths per year are caused by AAAs. The highest risk patients are men aged 65-75 years who have ever smoked (at least 100 cigarettes). Smoking is the most often predictor associated with AAA, with a direct correlation between the number of cigarettes consumed and the increasing risk of AAA.

Women aged 65-75 who have ever smoked or have a family history of AAA have a lower risk than the male demographic but may still benefit from POCUS screening. Patients with certain conditions such as atherosclerosis, vascular inflammation, high cholesterol/blood pressure, previous aneurysms, bacterial fungal infection in the aorta, and obesity may also be at risk and benefit from POCUS scanning for AAA.


AAA can be asymptomatic or can include any of the following:

  • Sudden pain in the abdomen or back
  • Pain that migrates from the abdomen back down to the pelvis, legs, or buttocks
  • Pulsating sensation near the naval
  • Dizziness and shortness of breath
  • Increased heart rate


The primary method of screening is abdominal ultrasound. This imaging modality has a high sensitivity (94%-100%) and specificity (98%-100%) for detecting AAA. POCUS is an easy test to perform and is non-invasive, so most at-risk patients are generally good candidates to be screened. It is highly accurate in detecting and determining the size of an AAA. High-risk patients should have a one-time routine screening, and lower-risk individuals should be selectively screened. Patients who have never smoked and have no family history of AAA may not benefit from routine screening.

The entire abdominal aorta is scanned. The average diameter of a male’s aorta is 1.7 cm, and in a female, 1.5 cm. The measurement is taken in the upper, mid and lower abdominal aorta. The diameter of the aorta is recorded in both the transverse and mid longitudinal plane. The diameter of the aortic is measured. If the diameter of the aorta is more than 3.0 cm, AAA is diagnosed. Aneurysms can grow up to 25 cm in diameter.

The shape of an aneurysm can be fusiform or saccular. The saccular aneurysm is rarer than the fusiform type.


Small and medium AAAs that are determined to be low risk of rupture are monitored with periodic screening to assess their growth rate. The risk of rupture is 11% or less in AAAs less than 5.9 cm in diameter. There is no standard interval for scanning these low-risk AAAs, and patient history should be used to inform a recommended interval. If the patient currently smokes, the recommendation would be to stop immediately.

AAAs greater than 5.5 cm or have shown a growth increase of 1 cm per year in diameter are considered high risk of rupture. Endovascular aneurysm repair is the most common treatment option for intact and unruptured AAAs.


Timely detection of AAAs can result in treatment to avert potentially fatal outcomes. Since POCUS screening is non-invasive, inexpensive, and highly sensitive in diagnosing AAAs, routine screening of men 65 years and older who have high levels of blood cholesterol, a family history of cardiovascular disease, or a history of smoking can reduce the rate of mortality.

Bring POCUS for AAA to 2022 POCUS World: Learn more here.

Looking for more information?

Fill out the form below or email us at POCUS@Inteleos.org to get more info.
  • This field is for validation purposes and should be left unchanged.

[gravityform id="66" ajax="true"]
<div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_66' ><div id='gf_66' class='gform_anchor' tabindex='-1'></div> <div class='gform_heading'> <h3 class="gform_title">Get your POCUS Guide - POPUP</h3> <span class='gform_description'></span> </div><form method='post' enctype='multipart/form-data' target='gform_ajax_frame_66' id='gform_66' action='/patients-who-should-be-screened-for-abdominal-aortic-aneurysm/#gf_66' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_66' class='gform_fields top_label form_sublabel_below description_below'><li id="field_66_1" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_66_1"><label class='gfield_label screen-reader-text' for='input_66_1' >Email Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_66_1' type='email' value='' class='form-control medium' placeholder='Email Address' aria-required="true" aria-invalid="false" /> </div></li><li id="field_66_3" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_66_3"><div class='ginput_container ginput_container_text'><input name='input_3' id='input_66_3' type='hidden' class='gform_hidden' aria-invalid="false" value='https://www.pocus.org/patients-who-should-be-screened-for-abdominal-aortic-aneurysm/' /></div></li><li id="field_66_4" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_66_4"><label class='gfield_label' for='input_66_4' >Comments</label><div class='ginput_container'><input name='input_4' id='input_66_4' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_66_4'>This field is for validation purposes and should be left unchanged.</div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_66' class='gform_button button' value='Download POCUS Guide' onclick='if(window["gf_submitting_66"]){return false;} if( !jQuery("#gform_66")[0].checkValidity || jQuery("#gform_66")[0].checkValidity()){window["gf_submitting_66"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_66"]){return false;} if( !jQuery("#gform_66")[0].checkValidity || jQuery("#gform_66")[0].checkValidity()){window["gf_submitting_66"]=true;} jQuery("#gform_66").trigger("submit",[true]); }' /> <input type='hidden' name='gform_ajax' value='form_id=66&amp;title=1&amp;description=1&amp;tabindex=0' /> <input type='hidden' class='gform_hidden' name='is_submit_66' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='66' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_66' value='WyJbXSIsIjZmY2YxODJmMjQzYjkwYWE0YTkyM2JiYzA3ZGNhOGYzIl0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_66' id='gform_target_page_number_66' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_66' id='gform_source_page_number_66' value='1' /> <input type='hidden' name='gform_field_values' value='' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js_2" name="ak_js" value="208"/><script>document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div> <iframe style='display:none;width:0px;height:0px;' src='about:blank' name='gform_ajax_frame_66' id='gform_ajax_frame_66' title='This iframe contains the logic required to handle Ajax powered Gravity Forms.'></iframe> <script type="text/javascript"> gform.initializeOnLoaded( function() {gformInitSpinner( 66, 'https://www.pocus.org/wp-content/plugins/gravityforms/images/spinner.svg' );jQuery('#gform_ajax_frame_66').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_66');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_66').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_66').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_66').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_66').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery('#gform_wrapper_66').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_66').val();gformInitSpinner( 66, 'https://www.pocus.org/wp-content/plugins/gravityforms/images/spinner.svg' );jQuery(document).trigger('gform_page_loaded', [66, current_page]);window['gf_submitting_66'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_66').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_66').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [66]);window['gf_submitting_66'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_66').text());}, 50);}else{jQuery('#gform_66').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [66, current_page]);} );} ); </script>