Your AAA screening letter: what the result means
What’s in the blog?
What the screening scan measures, and who is invited for one.
What each of the four result bands means, and what happens after each.
Why a small aneurysm is monitored rather than operated on.
What the scan is
The aorta is the main artery running from the heart down through the abdomen. In some people, usually later in life, a section of it gradually widens. That widening is an abdominal aortic aneurysm, and it very rarely produces any symptoms — which is exactly why it is screened for rather than waited for.
The NHS Abdominal Aortic Aneurysm Screening Programme invites men in England for a single ultrasound scan in the year they turn 65. It takes a few minutes, involves gel and a probe on the skin of the abdomen, and measures the widest point of the aorta. There are no needles and nothing to prepare for.
Men over 65 who were never screened can ask to be scanned; the invitation simply does not arrive automatically after that age.
What your result means
Results fall into four bands, and the band determines what happens next.
Normal, under 3cm. No aneurysm was found. You are not invited again, because an aorta of normal width at 65 is very unlikely to become a problem later.
Small, 3.0 to 4.4cm. A small aneurysm. You are offered an ultrasound scan once a year to watch whether it changes.
Medium, 4.5 to 5.4cm. You are offered a scan every three months, for the same reason but more closely.
Large, 5.5cm or more. You are referred to a vascular specialist to discuss treatment. This is a conversation about the options available.
Why monitoring rather than treatment
This is the part that most often surprises people, and it is worth explaining properly.
A small aneurysm is monitored rather than repaired because repairing it would not make you safer. Any operation on the aorta carries its own risk, and below a certain size that risk is greater than the risk of leaving the aneurysm alone and watching it. The 5.5cm threshold is where the balance shifts — and it is a threshold that has been examined repeatedly and left unchanged.
So surveillance is itself the treatment plan. The great majority of small aneurysms grow slowly, and many never reach the point of needing anything done.
What you can do while under surveillance
The things that influence how an aneurysm behaves are the same things that influence arteries generally, and they sit with your GP rather than with a surgeon.
Stopping smoking is the single most useful one by a clear margin. Blood pressure control matters, as does cholesterol, and keeping active within whatever is comfortable for you.
The scans themselves matter too. The interval you are given is chosen for the size of your aorta, and surveillance works best when it is kept to.
When to get help urgently
Sudden severe pain in the abdomen or back, particularly with feeling faint or unwell, needs an ambulance. This is rare and it is not what surveillance scans are for — but it is the one thing worth knowing.
Getting a specialist opinion
If you have been placed under surveillance and would like to talk the result through with a vascular surgeon — what the measurement means, what the interval is for, what would change the plan — that is a reasonable thing to want, and it is something our consultants see people for regularly.
You can arrange an appointment with Nottingham Vascular Clinic directly.
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