{"id":24797,"date":"2025-07-23T09:04:36","date_gmt":"2025-07-23T08:04:36","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=24797"},"modified":"2025-07-23T13:50:12","modified_gmt":"2025-07-23T12:50:12","slug":"abdominal-aortic-aneurysm","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/vascularsurgery\/abdominal-aortic-aneurysm\/","title":{"rendered":"Abdominal Aortic Aneurysm"},"content":{"rendered":"\n<p>Abdominal aortic aneurysm is focal dilatation that usually effects the infrarenal aorta. It is a degenerative condition that shares risk factors with atherosclerosis. The prevalence in men over 65 years of age is 7-8% and the condition is 5-6 times more common than in women. The incidence and prevalence of AAA is falling. An aneurysm of &lt;5.5cm AP diameter has a &lt;1% annual risk of rupture. There is a National AAA screening programme for men 65 years and older.&nbsp;<\/p>\n\n\n\n<p>Email Advice:&nbsp;<a href=\"mailto:VascularAdvice@nhslothian.scot.nhs.uk\"><strong>VascularAdvice@nhslothian.scot.nhs.uk<\/strong><\/a><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Refer to Vascular Surgeons<\/strong><\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who to refer:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with a finding of abdominal aortic aneurysm (AAA \u2013 an aorta with a diameter \u22653cm). Typically patients should have a confirmed AAA on imaging but in cases where a large expansile\/ pulsatile mass is palpable referral should not be delayed<\/li>\n\n\n\n<li>Men under the age of 65 and women of any age with a strong family history of aneurysm disease who are seeking or have been advised to undergo screening: that advice is often given by vascular units and applies particularly to sons or brothers of those developing large AAAs at a young age.<\/li>\n\n\n\n<li>Men over the age of 65 can self refer to the AAA screening service (see below).<\/li>\n\n\n\n<li>Patients with a confirmed AAA who experience abdominal\/back\/loin pain or tenderness on palpation of the aneurysm or have evidence of distal embolisation &#8211; Such patients should be discussed directly with the Vascular Surgery Registrar on-call at the Royal Infirmary of Edinburgh (available 24 hours\/day via switchboard) and emergency transport to A&amp;E \u2013 NOT the vascular ward \u2013 at the Royal Infirmary of Edinburgh arranged. These patients will be assessed by the Vascular Surgery team on arrival in A&amp;E.<\/li>\n\n\n\n<li>Patients without a confirmed AAA where a ruptured or symptomatic AAA is a differential diagnosis &#8211; Such patients should also be discussed with the Vascular Surgery Registrar and emergency transport to A&amp;E NOT the vascular ward at the Royal Infirmary of Edinburgh arranged. These patients will be assessed by the A&amp;E team and if appropriate referred onto the vascular service.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who not to refer to the Vascular Surgeons but rather the AAA screening service<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u00a0Men over 65 who are not known to have a confirmed AAA can self refer for a one off AAA screening ultrasound through our national aneurysm screening programme<\/li>\n<\/ul>\n\n\n\n<p>The AAA Screening Service can be contacted on 0131 242 3606<\/p>\n\n\n\n<p>More information can be found at:<a href=\"https:\/\/www.nhsinform.scot\/healthy-living\/screening\/abdominal-aortic-aneurysm-aaa\/abdominal-aortic-aneurysm-aaa-screening\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>https:\/\/www.nhsinform.scot\/healthy-living\/screening\/abdominal-aortic-aneurysm-aaa\/abdominal-aortic-aneurysm-aaa-screening<\/strong><\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>How to refer:<\/strong><\/h4>\n\n\n\n<p>SCI Gateway (Basic SIGN Referral) for asymptomatic aneurysms<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Asymptomatic aneurysms should be referred via Sci-Gateway (RIE &gt; Vascular Surgery &gt; Basic Sign Referral).\u00a0<strong>AAA greater than 5cm\u00a0<\/strong>should be marked as<strong>\u00a0urgent AAA.<\/strong><\/li>\n\n\n\n<li>Patients with a\u00a0<strong>confirmed AAA\u00a0<\/strong>who\u00a0<strong>experience abdominal\/back\/loin pain or tenderness on palpation<\/strong>\u00a0of the aneurysm or\u00a0<strong>evidence of distal embolisation.<\/strong>Such patients should be discussed directly with the Vascular Surgery Registrar on-call at the Royal Infirmary of Edinburgh (available 24 hours\/day via switchboard) and emergency transport to A&amp;E \u2013 NOT the vascular ward \u2013 at the Royal Infirmary of Edinburgh<\/li>\n\n\n\n<li>Patients\u00a0<strong>without a confirmed AAA\u00a0<\/strong>where a\u00a0<strong>ruptured or symptomatic AAA is a differential diagnosis<\/strong>\u00a0\u00a0 Such patients should also be discussed with the Vascular Surgery Registrar and emergency transport to A&amp;E NOT the vascular ward at the Royal Infirmary of Edinburgh arranged. These patients will be assessed by the A&amp;E team and if appropriate referred onto the vascular service<\/li>\n<\/ul>\n\n\n\n<p><strong>Information to include in referral:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Description of how AAA was detected (ie palpation\/imaging modality)<\/li>\n\n\n\n<li>Maximum AP diameter (Small: 3cm-4.4cm, Medium: 4.5cm-5.4cm, Large 5.5cm+)<\/li>\n\n\n\n<li>Presence or absence of cardiovascular risk factors, and how these have been addressed<\/li>\n\n\n\n<li>Co-morbidities<\/li>\n\n\n\n<li>Functional and Cognitive status<\/li>\n<\/ul>\n\n\n\n<p><strong>Best Medical Therapy to institute with referral<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Smoking cessation<\/li>\n\n\n\n<li>Antiplatelet agent (Aspirin first line)<\/li>\n\n\n\n<li>Statin therapy<\/li>\n\n\n\n<li>Exclude \/ manage hypertension<\/li>\n\n\n\n<li>Exclude \/ manage diabetes<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>Best Medical Therapy to institute with referral<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Smoking cessation<\/li>\n\n\n\n<li>Antiplatelet agent (Aspirin first line)<\/li>\n\n\n\n<li>Statin therapy<\/li>\n\n\n\n<li>Exclude \/ manage hypertension<\/li>\n\n\n\n<li>Exclude \/ manage diabetes<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Abdominal aortic aneurysm is focal dilatation that usually effects the infrarenal aorta. It is a degenerative condition that shares risk factors with atherosclerosis. The prevalence in men over 65 years of age is 7-8% and the condition is 5-6 times more common than in women. The incidence and prevalence of AAA is falling. An aneurysm<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":4504,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[1284],"class_list":["post-24797","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-abdominal-aortic-aneurysm"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/vascularsurgery\/https-apps-nhslothian-scot-refhelp-abdominal-aortic-aneurysm\/\" rel=\"tag\">Abdominal Aortic Aneurysm<\/a>","rttpg_excerpt":"Abdominal aortic aneurysm is focal dilatation that usually effects the infrarenal aorta. It is a degenerative condition that shares risk factors with atherosclerosis. The prevalence in men over 65 years of age is 7-8% and the condition is 5-6 times more common than in women. The incidence and prevalence of AAA is falling. An aneurysm","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/24797","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=24797"}],"version-history":[{"count":1,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/24797\/revisions"}],"predecessor-version":[{"id":24798,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/24797\/revisions\/24798"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4504"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=24797"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=24797"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}