Published January 2021
Contents
We found that a section of your abdominal aorta is a lot wider than expected. This means you have a large abdominal aortic aneurysm (AAA) that should be assessed for treatment options.
Around one man out of 1,000 (0.1%) who go for screening have a large AAA. This condition has almost certainly been present for some time, developing very slowly.
The aorta is the main blood vessel that supplies blood to the body. Sometimes the wall of the aorta in the abdomen can become weak and stretch to form an aneurysm. When this happens there is a risk that the aorta may split or tear, which is called a rupture. The larger the AAA, the bigger the risk of rupture.
3cm - 4.4cm
4.5cm - 5.4cm
A large AAA is serious because the risk of a rupture to the aorta wall increases with AAA growth. A ruptured AAA leads to serious internal bleeding, which can be fatal.
If you have been diagnosed with a large AAA and have new symptoms of severe, persistent abdominal or lower back pain (or both), you should go to an accident and emergency department immediately. Make sure you tell any medical staff that you have a large AAA found through screening.
If you contact a health professional for any other reason, you should again let them know that you have a large AAA found through screening.
We will contact you by phone within five days of your AAA scan. We will discuss your result in more detail and give you advice on your general health and how other conditions may affect your AAA. The hospital specialist nurse will also contact you.
If you have any immediate concerns, you can contact the local screening office in your area. You can also contact your GP.
You will be sent a letter with an appointment to meet the hospital specialist team who will offer advice and assess your options for managing your AAA. This appointment will usually take place within two weeks of your scan. Please make sure that you are available during this period and change any travel plans you may have. If you change address in the meantime, please tell the local screening office as soon as possible.
We will also write to your GP with the result of your scan.
The specialists:
After being assessed by the specialists, you may be offered an operation to treat your large AAA. All men will have the opportunity to ask the specialists any questions they may have.
Generally there are two types of treatment available.
1. Open repair: This is an operation that stitches a piece of material, called a graft, inside the abdominal aorta, to strengthen the artery at the point of the AAA and reduce the chance of it rupturing. It is done through a large cut in your abdomen.
2. Endovascular aneurysm repair (EVAR): This is an operation that places an artificial piece of artery, called a stent, inside your abdominal aorta, to strengthen the abdominal aorta at the point of the AAA and reduce the chance of it rupturing. It is done through small cuts in your groin to access your arteries. You will need follow-up scans to make sure that the stent has not moved.
For most men diagnosed with a large AAA, surgery is the most effective treatment, but having an operation is your choice. If you do not want to have an operation, the specialists will discuss this with you.
All operations have risks. When you see the specialist team, they will talk to you about treatment and the possible risks. The specialist team will talk to you about the right treatment for you.
The chances of recovery from AAA surgery are much better than the chances of recovery if the large AAA is ignored and later ruptures. If this happens, it can be fatal.
For a small number of men, an operation may have very high risks. This is usually when they have other serious medical conditions. If this is the case, the hospital specialist team will discuss this with you.
There are some things you can do that may slow the growth of your AAA. The following general recommendations may be helpful, particularly if surgery is being considered.
The Driver and Vehicle Licensing Agency (DVLA) is responsible for deciding whether people can drive on the basis of their health or any conditions they may have.
Having a large AAA may mean you must not drive until you have received treatment. Your GP and the hospital specialist team can advise you whether or not you should drive.
Latest information can be found on the GOV.UK website.
For more information about anything in this leaflet:
You can also get information and support from the Circulation Foundation. This is a UK charity for people who have diseases of the veins and arteries, known as vascular diseases, including AAA.
The Vascular Society of Great Britain and Ireland is a registered charity set up to preserve, promote and protect the health of the public through excellence and innovation in vascular health, through education, audit and research.