Probability of Having an Abdominal Aortic Aneurysm

Abdominal aortic aneurysm (AAA) is present in approximately 5-10% of men aged 65-75 and about 1% of women in the same age group. The US Preventive Services Task Force recommends one-time ultrasound screening for men aged 65-75 who have ever smoked. About 200,000 people in the US are diagnosed with AAA each year.

AAA occurs when the wall of the aorta (the body's largest artery) weakens and bulges. Most AAAs grow slowly and may never rupture, but large or rapidly growing aneurysms can burst, causing massive internal bleeding. AAA rupture is fatal in about 80% of cases, and even with emergency surgery, mortality is about 50%. Approximately 10,000-15,000 AAA-related deaths occur in the US each year, making it the 13th leading cause of death.

Risk factors include male sex (6 times more common in men), smoking (the strongest modifiable risk factor, increasing risk 4-5 times), age over 65, family history, hypertension, and atherosclerosis. Small aneurysms (less than 5.5 cm) are typically monitored with regular ultrasound surveillance. Repair is recommended for aneurysms 5.5 cm or larger, with options including open surgical repair and endovascular repair (EVAR, a less invasive approach using a stent graft). Elective repair has a mortality rate of about 1-5%.