Modalities for aneurysm imaging

Aneurysm imaging. We recommend using ultrasound, when feasible, as the preferred imaging modality for aneurysm screening and surveillance. Level of recommendation: 1 (Strong), Quality of evidence: A (High)

We suggest that the maximum aneurysm diameter derived from computed tomography (CT) imaging should be based on an outer wall to outer wall measurement perpendicular to the path of the aorta. Level of recommendation: Good Practice Statement, Quality of evidence: Ungraded

Prediction of aneurysm expansion and rupture risk

We recommend a one-time ultrasound screening for AAAs in men or women 65 to 75 years of age with a history of tobacco use. Level of recommendation: 1 (Strong), Quality of evidence A (High)

We suggest ultrasound screening for AAA in firstdegree relatives of patients who present with an AAA. Screening should be performed in first-degree relatives who are between 65 and 75 years of age or in those older than 75 years and in good health. Level of recommendation: 2 (Weak), Quality of evidence: C (Low)

We suggest a one-time ultrasound screening for AAAs in men or women older than 75 years with a history of tobacco use and in otherwise good health who have not previously received a screening ultrasound examination. Level of recommendation: 2 (Weak), Quality of evidence: C (Low)

If initial ultrasound screening identified anaortic diameter >2.5 cm but <3 cm, we suggest rescreening after 10 years. Level of recommendation: 2 (Weak), Quality of evidence: C (Low)

Recommendations for aneurysm surveillance

We suggest surveillance imaging at 3-year intervals for patients with an AAA between 3.0 and 3.9 cm. Level of recommendation: 2 (Weak), Quality of evidence: C (Low)

We suggest surveillance imaging at 12-month intervals for patients with an AAA of 4.0 to 4.9 cm in diameter. Level of recommendation: 2 (Weak), Quality of evidence: C (Low)

We suggest surveillance imaging at 6-month intervals for patients with an AAA between 5.0 and 5.4 cm in diameter. Level of recommendation: 2 (Weak), Quality of evidence: C (Low)

Recommendations for imaging of symptomatic patient

We recommend a CT scan to evaluate patients thought to have AAA presenting with recent-onset abdominal or back pain, particularly in the presence of a pulsatile epigastric mass or significant risk factors for AAA. Level of recommendation: 1 (Strong) Quality of evidence: B (Moderate)