Abdominal aortic aneurysm (AAA) screening

The aim of abdominal aortic aneurysm (AAA) screening is to find aneurysms (bulges in blood vessels) early and monitor or treat them. AAA screening doesn't look for other health conditions.

Treating an AAA early greatly reduces the chance of it rupturing and causing serious problems.

What's an AAA?

The aorta is the main artery that supplies blood to your body. It runs from your heart down through your chest and abdomen (tummy).

As you get older, the wall of the aorta in your abdomen can become weak and balloon out. This is called an abdominal aortic aneurysm or AAA.

Who's at risk?

Men are 6 times more likely to have this type of aneurysm than women.

Aneurysms can happen in all men. However, there's a higher chance if:

• you're aged 65 and over
• you smoke
• you have high cholesterol
• you have high blood pressure
• your brother, sister or parent has had an aneurysm

Who'll be screened?

In Scotland, all men aged 65 are invited to attend AAA screening.

If you’re over 65 and have never been for AAA screening, you can arrange an appointment by phoning your local AAA screening centre.

AAA screening for transgender and non-binary people

What does it involve?

To find out if you have an AAA, a health professional will take an ultrasound scan (sonogram) of your abdomen.

These scans are:

• completely safe, reliable and painless
• quick, usually lasting for around 10 minutes

More about taking the test

Your screening invitation

When you get your invitation, read the information carefully and decide whether you want to take up the invitation.

If you're unsure, look for further information to help you decide or talk to a trusted local health professional.

If you decide to take up the invitation, contact your local screening centre as soon as possible if you:

• want to have someone else with you during the scan
• have a disability
• need an interpreter or any other help

Choosing not to be screened

It’s your choice whether to be screened or not. However, your local screening centre will only send one invitation.

If you choose not to be screened but change your mind later, you can arrange an appointment by phoning your local AAA screening centre.

Your experience may be slightly different from usual because the local programmes will have additional safety measures in place.

You may be phoned prior to your appointment giving you specific instructions about what to do when you arrive, and ask you to

• arrive as close to the appointment time as possible
• wear a face covering during your appointment, in line with national guidance.
• wait outside the building, sometimes at a specific door and always keeping distance from other people. If you are invited to wait inside, they will follow government guidance and make sure everyone is spaced apart from each other.

The ultrasound scan itself, where your screener moves a small scanner over your skin and take measurements of your aorta from an image on a screen, will be exactly the same and should only take a couple of minutes.

It's important to know what an abdominal aortic aneurysm (AAA) is, why screening is offered and what happens at a screening appointment. This information will help you decide whether you want to go for AAA screening.

Benefits

The AAA screening test can help to identify whether you've an aneurysm that needs to be monitored or treated. If you've an aneurysm, you may feel completely healthy with no symptoms or pain. If left untreated, aneurysms can cause serious problems.

An ultrasound scan is a completely safe, painless and reliable test.

Risks

There are no risks associated with this ultrasound screening test. It's the same technique that's used to examine the development of a baby during pregnancy.

However, aneurysms, when left undetected and untreated, can be life-threatening. As the wall of the aorta stretches, it becomes weaker and could rupture (burst) causing internal bleeding. Where internal bleeding occurs, 8 out of 10 cases result in death.

The easiest and most effective way to find out if you have an aneurysm is to have an ultrasound scan (sonogram) of your abdomen. An ultrasound scan is a procedure that uses high-frequency sound waves to create an image of the inside of your body.

You'll have the test at your nearest screening centre.

Accessibility

When you receive your appointment, please let the staff at the screening centre know if:

• you've access issues that prevent you attending your appointment or may cause difficulty during your appointment
• you require an interpreter during your appointment
• you require any other help or want to have someone with you during the scan

Before the test

At the screening centre, a health professional will check your details and explain the test. You'll have a chance to ask questions.

There's no need to fast before your scan. But if you can, avoid having a heavy meal to help the person doing your test get a clearer image.

During the test

The person doing your test will:

• ask you to lie down and lift up, or unbutton, your shirt
• apply a cool jelly to your abdomen
• move a small scanner over your skin
• take measurements of your aorta from an image on a screen

Your appointment will usually take no more than 30 minutes with the test itself taking around 10 minutes.

More about ultrasound scans

Second test

Sometimes they won't be able to see the aorta clearly. This is nothing to worry about. However, you’ll need to be retested to get an accurate result.

The screening centre will arrange a new appointment for you. This could be on a different day and at another clinic.

After the scan:

• the person who carried out the ultrasound will tell you your result straight away
• you'll be sent a result letter in the post

If you have an aneurysm, your GP will be sent a copy of the result letter so they can discuss your results with you.

Normal result

Most men have a normal result, which means:

• no aneurysm was found
• you won't need any further investigations or treatment
• you don't need to be screened again, as it’s very unlikely you'll develop an aneurysm that needs treatment

Small, medium or large aneurysm

If your result isn't normal, it will show whether you have a small, medium or large aneurysm.

These don't require treatment but will be monitored.

Small or medium aneurysm

If your aorta's a little bigger than normal, you'll test positive for a small or medium aneurysm.

Most aneurysms grow very slowly, and many men with a small or medium aneurysm never need treatment. However, it's important to check the size of the aneurysm regularly to monitor any growth as you may need treatment if it grows into a large aneurysm.

To monitor growth, your local screening centre will invite you for an ultrasound scan every:

• 12 months for a small aneurysm
• 3 months for a medium aneurysm

A health professional will also tell you what you can do to stop your aneurysm getting larger.

Large aneurysm

A large aneurysm means your aorta is much bigger than normal. Only a very small number of men will have a large aneurysm.

Large aneurysms are uncommon but can be very serious. As the wall of the aorta stretches, it becomes weaker, and it could rupture (burst). If the aneurysm ruptures, this leads to life-threatening internal bleeding and, in 8 out of 10 cases, death.

Your local screening centre will refer you to a specialist consultant, who'll:

• carry out more tests
• provide more detailed information
• discuss possible treatment with you, including surgery

You'll usually see a consultant within 4 weeks.

Treating a large aneurysm

The operations available to treat large aneurysms also have risks, and can sometimes result in serious complications, leading to death. However, it's known that operations on large aneurysms found through screening have a much lower risk of death than if the aneurysm ruptures on its own.

The risks of rupture and surgery vary from person to person. If you have a large aneurysm and surgery is a treatment option, a surgeon will explain in detail the risks of:

• leaving the aneurysm untreated
• having the operation to treat the aneurysm

If surgery isn't possible, there may be no other appropriate treatments.

Ruptures (bursts)

If you've been diagnosed with an aneurysm, and have unusual or unexplained abdominal or lower back pain:

• phone your GP now
• phone the 111 service if your GP surgery is closed

When you phone, tell the health professionals you've an aneurysm and have been referred for assessment.

If you're unsure about anything or have questions about abdominal aortic aneurysm (AAA) screening, phone:

• your local AAA screening centre
• the NHS inform helpline

AAA screening leaflets

Public Health Scotland has produced:

• leaflets explaining AAA screening in Scotland, including why it's offered and what happens next if the test finds a small, medium or large aneurysm
• a leaflet about your AAA screening appointments during coronavirus (PDF, 255Kb)

These leaflets are also available in other languages and in Easy Read, British Sign Language (BSL) and audio format.​