title: [Ultrasound screening of abdominal aortic aneurysm: Lessons from Vesale 2013].
abstract: Although aneurysm of the abdominal infra-renal aorta (AAA) meets criteria warranting B mode ultrasound screening, the advantages of mass screening versus selective targeted opportunistic screening remain a subject of debate. In France, the French Society of Vascular Medicine (SFMV) and the Health Authority (HAS) published recommendations for targeted opportunistic screening in 2006 and 2013 respectively. The SFMV held a mainstream communication day on November 21, 2013 in France involving participants from metropolitan France and overseas departments that led to a proposal for free AAA ultrasound screening: the Vesalius operation. Being a consumer operation, the selection criteria were limited to age (men and women between 60 and 75 years); the age limit was lowered to 50 years in case of direct family history of AAA. More than 7000 people (as many women as men) were screened in 83 centers with a 1.70% prevalence of AAA in the age-based target population (3.12% for men, 0.27% for women). The median diameter of detected AAA was 33 mm (range 20 to 74 mm). The prevalence of AAA was 1.7% in this population. Vesalius data are consistent with those of the literature both in terms of prevalence and for cardiovascular risk factors with the important role of smoking. Lessons from Vesalius to take into consideration are: screening is warranted in men 60 years and over, especially smokers, and in female smokers. Screening beyond 75 years should be discussed. Given the importance of screening, the SFMV set up a year of national screening for AAA (Vesalius operation 2014/2015) in order to increase public and physician awareness about AAA detection, therapeutic management, and monitoring. AAA is a serious, common, disease that kills 6000 people each year. The goal of screening is cost-effective reduction in the death toll.
authors.affiliation: Médecine interne et médecine vasculaire, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France. Electronic address: echoraljp@gmail.com.
authors.forename: J P
authors.initials: JP
authors.lastname: Laroche
authors.affiliation: 40, chemin des Favrands, 74400 Chamonix-Mont-Blanc, France.
authors.forename: F
authors.initials: F
authors.lastname: Becker
authors.affiliation: Centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Baud
authors.affiliation: 55, rue Gambetta, 78120 Rambouillet, France.
authors.forename: G
authors.initials: G
authors.lastname: Miserey
authors.affiliation: Unité de recherche clinique et épidémiologie, CHRU de Montpellier, 191, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Jaussent
authors.affiliation: Unité de recherche clinique et épidémiologie, CHRU de Montpellier, 191, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Picot
authors.affiliation: Médecine vasculaire, hôpital Rangueil, CHRU de Toulouse, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Bura-Rivière
authors.affiliation: Médecine interne et médecine vasculaire, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
authors.forename: I
authors.initials: I
authors.lastname: Quéré
mesh_terms: D000367:Age Factors; D000368:Aged; D000886:Anthropometry; D001012:Aorta, Abdominal / Q000473:pathology; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000191:economics / Q000453:epidemiology / Q000235:genetics; D002309:Cardiology; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D004198:Disease Susceptibility; D042241:Early Diagnosis; D005260:Female; D005602:France / Q000453:epidemiology; D006552:Hernia, Inguinal / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012955:Societies, Medical; D014463:Ultrasonography
keywords: Abdominal aorta; Aneurysm; Anévrisme; Aorte abdominale; B Mode ultrasound; Dépistage; Screening; Échographie