Key result
AAA screening programs reduce prevalence and mortality, with future expansions relying on novel biomarkers and medications.
Why the study?
Two decades after the establishment of AAA screening programs, advances in diagnostics, surgical approaches, and pharmacological options warrant review to address progress, gaps, controversies, and future priorities.
This review highlights the success of national AAA screening programs in reducing mortality and advocates for their expansion using novel biomarkers and pharmacological treatments for small aneurysms.
May justify sustained AAA screening; leaves open optimal intervals and subgroups in modern cohorts.
Aortic aneurysm is a leading cause of death across the world. Many victicms carry it without knowing. Ruputre of aortic aneurysms leads to devastating sudden death. This brings trauma to families and our society. Based upon sound results out of several cohort studies, US Preventive Services Task Force (USPST) crafted the 1st nationwide abdominal aorta aneurysm (AAA) screening program in 2005. It was renewed and expanded in subsequent revisions in 2014 and 2019. UK and Sweden estalished their own programs as well. Since then, a significant decline in AAA prevalence and mortality has been observed. Two decades into the practice, the state of the art on diagnostics, surgical approaches, and pharmacological options have drastically changed. Patients previously ineligible for treatment or inconclusive on diagnostics now have valid options. The screening program is on the verge for a bold expansion. In this review, we summarize the chroncles leading to the inception of the screening programs, progress in interpretation after implementation including gains, gaps and controversies, advents of new technologies and approaches, new fronts facing us, as well as priorities to be addressed in future phases. Particularly, screening asssys with a clinically tested biomarker, tetrahydrobiopterin (H 4 B), enables unpresended accessibility, consistency and throughput to accommodate the needs of a larger population. Furthermore, patients with AAAs at size below the eligibility threhold for surgical intervention (e.g., < 5.5 cm) can be treated with novel oral medications. Confronting factors such as changing demographics and COVID-19 aftermath are putting up new challenges. Nevertheless, running a program at national scale demands both unwavering commitment and agile fine-tuning. Technical innovation will be an indispensable chapter of its continued success. The burden of aortic aneurysm-led sudden death is too heavy for any family and the society to bear; it is time to step up our resolve with additional capacities as discussed in the present review.
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Zong et al. (2024) conducted a review in Aortic aneurysm. Abdominal aorta aneurysm (AAA) screening was evaluated. Abdominal aorta aneurysm screening programs have led to a significant decline in AAA prevalence and mortality, with future expansions relying on novel biomarkers and oral medications.
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