Diagnosis
8
Aneurysm Imaging
➤ The SVS recommends using ultrasound, when feasible, as the preferred
imaging modality for aneurysm screening and surveillance. (1-A)
➤ The SVS suggests that the maximum aneurysm diameter derived from
computed tomography (CT) imaging should be based on an outer wall
to outer wall measurement perpendicular to the path of the aorta. (G-U)
➤ The SVS recommends a one-time ultrasound screening for AAAs in
men or women 65–75 years of age with a history of tobacco use. (1-A)
➤ The SVS suggests ultrasound screening for AAA in first degree
relatives of patients who present with an AAA. Screening should be
performed in first-degree relatives who are 65–75 years of age or in
those >75 years and in good health. (2-C)
➤ The SVS suggests a one-time ultrasound screening for AAAs in men
or women ≥75 years with a history of tobacco use and in otherwise
good health who have not previously received a screening ultrasound
examination. (2-C)
➤ If initial ultrasound screening identified an aortic diameter >2.5 cm
but <3 cm, the SVS suggests rescreening after 10 years. (2-C)
➤ The SVS suggests surveillance imaging at 3-year intervals for patients
with an AAA 3.0–3.9 cm. (2-C)
➤ The SVS suggests surveillance imaging at 12-month intervals for
patients with an AAA of 4.0–4.9 cm in diameter. (2-C)
➤ The SVS suggests surveillance imaging at 6-month intervals for
patients with an AAA 5.0–5.4 cm in diameter. (2-C)
➤ The SVS recommends a CT scan to evaluate patients thought to
have AAA presenting with recent-onset abdominal or back pain,
particularly in the presence of a pulsatile epigastric mass or
significant risk factors for AAA. (1-B)