Abdominal aortic aneurysm screening program using hand-held ultrasound in primary healthcare

by Antoni Sisó-Almirall, Belchin Kostov, Marta Navarro González, Daniel Cararach Salami, Alfonso Pérez Jiménez, Rosa Gilabert Solé, Concepció Bru Saumell, Lluís Donoso Bach, Mireia Villalta Martí, Luis González-de Paz, Rafael Ruiz Riera, Vicenç Riambau Alonso, Nihan Acar-Denizli, Marta Farré Almacellas, Manuel Ramos-Casals, Jaume Benavent Àreu

We determined the feasibility of abdominal aortic aneurysm (AAA) screening program led by family physicians in public primary healthcare setting using hand-held ultrasound device. The potential study population was 11,214 men aged ≥ 60 years attended by three urban, public primary healthcare centers. Participants were recruited by randomly-selected telephone calls. Ultrasound examinations were performed by four trained family physicians with a hand-held ultrasound device (Vscan^®). AAA observed were verified by confirmatory imaging using standard ultrasound or computed tomography. Cardiovascular risk factors were determined. The prevalence of AAA was computed as the sum of previously-known aneurysms, aneurysms detected by the screening program and model-based estimated undiagnosed aneurysms. We screened 1,010 men, with mean age of 71.3 (SD 6.9) years; 995 (98.5%) men had normal aortas and 15 (1.5%) had AAA on Vscan^®. Eleven out of 14 AAA-cases (78.6%) had AAA on confirmatory imaging (one patient died). The total prevalence of AAA was 2.49% (95%CI 2.20 to 2.78). The median aortic diameter at diagnosis was 3.5 cm in screened patients and 4.7 cm (p

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