title: Aortic aneurysms - screening, surveillance and referral.
abstract: BACKGROUND
  Aortic aneurysms are a common finding in elderly patients. Rupture of an aortic aneurysm is a catastrophic event associated with a very high mortality.
  
  
  OBJECTIVE
  To review the current literature on aortic aneurysmal disease, including the recommended referral threshold, surveillance guidelines and treatment options.
  
  
  CONCLUSIONS
  Screening of men aged 65 years and over has been shown to reduce aneurysm related mortality, however, no formal screening guidelines exist in Australia. In addition to the risk of aneurysm expansion and rupture, patients are at increased risk of cardiovascular morbidity and mortality. Small aneurysms should be managed with surveillance and cardiovascular risk factor modification. Large aneurysms should be referred promptly to a vascular surgeon for assessment and repair. Symptomatic and ruptured aneurysms require emergency assessment and treatment. Advances in endovascular techniques enable most patients with aortic aneurysms to be treated with minimally invasive stent grafts, which have lower perioperative complication rates than open repair.
authors.affiliation: Department of Vascular Surgery, Austin Hospital, Melbourne, Victoria. domenicrobinson@gmail.com
authors.forename: Domenic
authors.initials: D
authors.lastname: Robinson
authors.forename: Barend
authors.initials: B
authors.lastname: Mees
authors.forename: Hence
authors.initials: H
authors.lastname: Verhagen
authors.forename: Jason
authors.initials: J
authors.lastname: Chuen
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000628:therapy; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D001019:Aortic Rupture / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D001315:Australia / Q000453:epidemiology; D019917:Blood Vessel Prosthesis Implantation; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D057510:Endovascular Procedures; D006801:Humans; D008403:Mass Screening; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D012307:Risk Factors
chemical_list: D002317:Cardiovascular Agents