Abdominal aortic aneurysm in the Irish population: A familial screening study

Abstract

A pilot screening programme was undertaken in Ireland to determine the incidence of abdominal aortic aneurysm (AAA) (diameter 3 cm or greater) in the siblings of 120 patients known to have AAA. There were 621 siblings; 270 of them were dead, 32 were over 80 years old and 85 lived outside Ireland, leaving 234 under 80 years of age still living in Ireland who were invited to attend for ultrasonographic screening. Of the 270 siblings who had died, 102 were women and 168 men; eight men (4.8 per cent) had died from ruptured AAA. Only 125 (53.4 percent) of the 234 siblings agreed to participate in the screening programme, 60 brothers from 31 families and 65 sisters from 35 families. Fifteen (12.0 per cent) of the 125 siblings had an AAA (median size 4.2 (range 3.1-6.8) cm), 13 (22 per cent) of the 60 male siblings and two (3 per cent) of the 65 female siblings. The prevalence of AAA among siblings was not affected by the age or sex of the patient with aneurysm. Seven of the 14 male siblings with hypertension had an AAA, compared with only six of the 46 who were normotensive (P = 0.01). The high incidence of AAA in brothers of affected patients highlights the need to counsel this group on their risk of aneurysm. The relatively low participation rate by siblings in this screening programme indicates that a hospital-based unit is unlikely to be effective in recruiting all patient siblings at risk from an AAA.

Screening for abdominal aortic aneurysms during a basic medical checkup in residents of a Japanese rural community

“…[19][20][21][22] Using the SVS/ISCVS criteria, the upper limit of 30 mm is appropriate, 18 as most screening studies define an AAA by a maximum infrarenal diameter of more than 30 mm. [5][6][7][8][9]13,24,25 According to our screening, the mean abdominal aortic diameter was 17.2 mm, with 50% dilatation meaning 26 mm, but to compare results with other screening studies, 30 mm should be considered as an AAA in Japanese persons.…”

“…Two of the AAAs and one of the iliac arterial aneurysms were considered large enough to require surgery, among the nine aneurysms detected. A number of reports on AAA screening have been published in Europe and the United States, [3][4][5][6][7][8][9][10][11][12][13]24,25 but only a few reports on such screening in Japan 26 exist. The incidence of aneurysms in Japan has been estimated by autopsy analyses.…”

Familial Abdominal Aortic Aneurysms in the Otago Region of New Zealand

“…The incidence of familial AAA has been reported from between 5.1 and 20.6% [2,9,15,16,25,46,[50][51][52]. A positive family history has been shown to be an independent risk factor for the development of an abdominal aortic aneurysm [46].…”

“…The New Zealand population consists predominantly of people of European descent, mostly from the UK. The incidence of familial aneurysms seems to be much higher in New Zealand than the UK, where it ranges from 5 to 14% when a diameter of 3 em is used to define an AAA [15,16,26]. Interestingly, the incidence of familial AAA is also low in the USA, at 5.1 % [46] to 15.1 % [20] and is only 10% in Finland [53].…”

“…Opinions differ as to whether mass screening by ultrasound is cost effective [11][12][13]. However, if a sub population at greater risk, such as those with familial AAAs, can be identified, screening could be rendered more cost effective [14][15][16][17][18][19]. It has also been suggested that patients with familial AAA may have other phenotypic characteristics associated with their AAA making them more prone to rupture their AAA , [20].…”