What is an AAA  (Abdominal Aortic Aneurysm?)

An abdominal aortic aneurysm (AAA) is a swelling of the aorta. The aorta is the main blood vessel that supplies blood to your body. The abdominal aorta is the largest blood vessel in the body which runs from your heart down through your chest and abdomen (belly). The bulging or swelling (similar to that of a tyre) occurs when the wall of the aorta weakens. An AAA can be dangerous if it isn’t spotted early on.

Who are at risk of an AAA?

  • Men aged 65 and over are most at risk, 6 times more so than women.
  • In Northern Ireland 1 in 65 men aged over 65 has an AAA. To date (July 2019) almost 59,000 men have benefitted from the available screening programme and almost 900 aneurysms have been detected.
  • If you smoke or used to smoke, you’re up to 15 times more likely to get an AAA
  • High blood pressure can also double your risk of getting an AAA
  • You are about four times more likely to get an AAA if a close relative has had one

Symptoms of an AAA

AAA’ss do not usually cause any obvious symptoms and are often only picked up during screening or tests carried out for another reason.

Some people with an AAA have:

  • A pulsing sensation in the tummy (like a heartbeat)
  • Constant tummy pain
  • Lower back pain that doesn’t go away

If an AAA bursts, it can cause:

  • Sudden, severe pain in the tummy or lower back
  • Sweaty, pale and clammy skin
  • A racing heartbeat
  • Shortness of breath
  • Fainting or passing out
  • Dizziness

Benefits of AAA screening

Screening can detect an AAA before it bursts. If an AAA is left to get bigger and it bursts it can cause life-threatening bleeding inside your stomach. About 8 in every 10 people who have a burst AAA die before they get to hospital or do not survive emergency surgery to repair it. Research suggests screening can halve the risk of dying from an AAA.

Where does the screening take place?

There are screening clinics in all Healthcare Trust throughout Northern Ireland. We have listed these clinics below:

Belfast Trust

  • Arches Wellbeing and Treatment Centre
  • Beech Hall Wellbeing and Treatment Centre
  • Bradbury Wellbeing and Treatment Centre
  • Grove Wellbeing and Treatment Centre

Northern Trust

  • Ballymena Health and Care Centre
  • Causeway Hospital, Coleraine
  • Mid Ulster Hospital
  • Moyle Hospital, Larne

South Eastern Trust

  • Ards Hospital
  • Bangor Community Hospital
  • Downe Hospital
  • Lagan Valley Hospital, Lisburn

Southern Trust

  • Banbridge Health and Care Centre
  • Bessbrook Clinic, Newry
  • John Mitchell Place
  • Kilkeel Primary Care Centre
  • Lurgan Hospital
  • Mullinure Hospital
  • Portadown Health Centre
  • South Tyrone Hospital

Western Trust

  • Omagh Hospital
  • Roe Valley Hospital
  • South West Acute Hospital
  • Waterside Health Centre (Derry)

What happens during AAA screening

Screening for AAA involves a quick and painless ultrasound scan of your stomach, similar to the scan a pregnant woman has.

For the scan:

  • You lie down on a table and lift up or unbutton your top (you do not need to undress)
  • The technician rubs a clear gel on your stomach and moves a small handheld scanner over your skin – pictures from the scanner are shown on a monitor and the technician will measure how wide your aorta is
  • The gel is wiped off and the technician tells you the result straight away
  • The entire process should take approximately 15 minutes

Results of the screening

There are 4 possible screening results.

  • No aneurysm found if your aorta is less than 3cm wide, this means it’s not enlarged. Most men have this result. You will not need to have any treatment or monitoring afterwards, and will not be invited for AAA screening again.
  • Small AAA
  • Medium AAA
  • Large AAA

For further information, please visit the website www.aaascreening.info.  There are various video clips available about the screening programme

  • 1)An animation showing what a large (AAA) is (duration < 1 minute)
  • 2)Testimonial of a man on surveillance for an AAA (< 3 minutes)
  • 3)Guidance on what to expect when being screened (< 4 minutes)
  • 4)Testimonial of a man treated for a large AAA (< 6 mins)

Treatment

The recommended treatment for an AAA depends on its size.  Treatment is not always required if the risk of the AAA bursting is low but lifestyle changes will be advised. Treatment for a:

  • Small AAA (3cm to 4.4cm across). Just over 1% of men screened have a small AAA. Ultrasound scans are recommended every year to check if it’s getting bigger and you will be advised about healthy lifestyle changes to help stop it growing
  • Medium AAA (4.5cm to 5.4cm) about 0.5% of men screened have a medium AAA. Ultrasound scans are recommended every three months to check if it’s getting bigger, again you will be advised about healthy lifestyle changes
  • Large AAA (5.5cm or more) about 0.1% of men screened have a large AAA. Surgery to stop it getting bigger or bursting is usually recommended

Reduce your risk

There are several things you can do to reduce your chances of getting an AAA or to help stop one getting bigger.

These include:

  • Stopping smoking
  • Eating healthily, eat a balanced diet and cut back on fatty food
  • Exercise regularly
  • Watch your weight
  • Cutting down on alcohol

Finally, women and men under 65 aren’t routinely invited for screening. However, if you think you might have a higher risk of an AAA, talk to your GP about the possibility of having a scan. Also check your address is correct at the GP surgery, this will ensure you receive the invitation for a scan once you attain the age of 65.