vascular emergency-medicine

AAA Rupture Risk Estimation

Abdominal aortic aneurysm (AAA) rupture risk rises with diameter and is higher in women and smokers. Surveillance, referral and repair thresholds follow NICE NG156 and the NHS AAA Screening Programme.

Result

There is no validated AAA points score. Management follows diameter, growth and symptoms (NICE NG156): refer an AAA of 5.5 cm or more to a regional vascular service to be seen within 2 weeks, and one of 3.0–5.4 cm within 12 weeks; consider repair if it is symptomatic, 5.5 cm or more, or larger than 4.0 cm and has grown by more than 1 cm in a year. NHS AAA screening surveillance: 3.0–4.4 cm yearly, 4.5–5.4 cm every 3 months. Suspected rupture (new abdominal or back pain, collapse) needs immediate bedside ultrasound and discussion with the vascular service. Rupture risk rises with diameter and is higher in women and smokers: in patients unfit for repair (Brown 2003) about 1.0 % a year for men and 3.9 % for women at 5.0–5.9 cm, and 14.1 % and 22.3 % at 6.0 cm or more; small-AAA rupture rates are almost four times higher in women (RESCAN 2012).

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

References

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