An abdominal aortic aneurysm that bursts can cause potentially fatal internal bleeding. One-time screening with abdominal ultrasound is currently recommended for older men who have ever smoked.

In an aneurysm, the wall of an artery becomes weakened. This creates a bulge in the artery wall that has the potential to burst, leading to potentially life-threatening bleeding. Some aneurysms affect the aorta, the largest artery in your body.

According to the Centers for Disease Control and Prevention (CDC), aortic aneurysms led to 9,904 deaths in 2019. As such, it’s important to screen for abdominal aortic aneurysms (AAAs), the most common type of aortic aneurysm.

This article reviews current screening recommendations for AAAs, what screening is like, and what to expect from your results.

Language matters

In this article, we talk about screening for aortic aneurysms in people who were assigned male at birth. It’s important to note that not everyone assigned male at birth identifies with the label “man.” However, at times we use “man” or “men” to reflect the language in a study or a screening recommendation. When possible, we aim to be inclusive and create content that reflects the diversity of our readers.

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The abdominal aorta supplies oxygen-rich blood that travels to the organs and tissues of your abdomen and lower extremities. It’s the largest artery in the body and is typically 2 centimeters (cm) wide, about the width of a garden hose.

An AAA is when part of the wall of your abdominal aorta weakens and bulges out. It’s diagnosed when the width of your abdominal aorta becomes at least 50% larger than normal, generally 3 cm (1.18 inch) or larger.

There are several risk factors for AAA, including:

An AAA is diagnosed using imaging tests. Typically, the first test used is ultrasound. Other imaging tests that may be used during diagnosis include CT scans, MRI scans, and echocardiograms.

The U.S. Preventative Services Task Force recommends that all men ages 65–75 years who have ever smoked be screened for AAA.

This is a one-time screening. It’s done using an abdominal ultrasound.

Cost of screening

Under the Affordable Care Act (ACA), insurance plans must cover certain preventative services, including one-time screening for AAA, without charging a copay or coinsurance.

One-time AAA screening is also covered under Medicare Part B for at-risk individuals. At-risk individuals include those with a family history of AAA or men ages 65–75 who’ve smoked at least 100 cigarettes during their life.

If you don’t have insurance, free or low-cost AAA screening may be available by going to a community health center. Find one in your area here.

Screening for AAA is done using an abdominal ultrasound. This is a painless, noninvasive imaging test. The entire ultrasound process is short, taking 10–15 minutes.

For the ultrasound, you’ll be asked to lie down on a table and unbutton or lift up your shirt. You won’t need to undress.

The technician will then rub a clear gel onto your stomach. The gel helps sound waves to better travel from the ultrasound probe to your skin, promoting clear images.

After applying the gel, the technician will move the probe across your stomach. The sound waves from the probe are reflected back by the tissues of your body, allowing for images to be generated on a screen near to the technician.

At the end of the ultrasound, the technician will clean away the gel and ask you to button or pull down your shirt.

After your ultrasound is done, a radiologist will review the images to assess the width of your abdominal aorta. You may receive your results right away or may need to wait a few days for a report.

If no AAA is detected, you won’t need another screening. If an AAA is found, next steps depend on its size.

Generally speaking, a small-to-medium sized AAA may be monitored every 6–12 months to make sure that it isn’t becoming larger. If the AAA is found to be growing in size at a follow-up ultrasound, repair will be recommended.

Treatment is typically recommended for an AAA that’s larger than 5.4 cm (2.12 inches), as these are at the highest risk of bursting. Treatment typically involves surgery to repair the aneurysm.

Regardless of the size of your AAA, your doctor will recommend lifestyle changes, such as:

An AAA is a potentially life-threatening condition. Some people are at a higher risk of AAA, including older individuals, people assigned male at birth, and those who smoke or have health conditions such as atherosclerosis and high blood pressure.

It’s recommended that people assigned male at birth ages 65–75 who have ever smoked receive a one-time AAA screening via abdominal ultrasound. This is a painless test that takes only a short amount of time.

If your screening finds an AAA, next steps depend on its size. While many AAAs can be monitored periodically, large AAAs are at a high risk of bursting. In these situations, surgery to repair the AAA is typically recommended.