HNY Policy and Pathway Repository - Humber

Large aneurysms are rare. If a large aneurysm bursts, it causes internal bleeding and is usually fatal.

AAAs are most common in men aged over 65. A rupture accounts for more than 1 in 50 of all deaths in this group and a total of 6,000 deaths in England and Wales each year.

Do not refer

Men or women under 65 years of age should not be referred to the National AAA Screening Programme

Women of any age should not be referred to the National AAA Screening Programme

If a scan has an incidental finding of an aneurysm, the person should be referred to Vascular Surgery (as detailed in referrals)

No Guidelines on Management Listed

Men aged 65 (in the year of their 65th birthday) are offered screening by the National AAA Screening Programme

Referral

1) Screening Tests

All men are invited for a screening test in the year that they turn 65 by NAAASP. The test involves an ultrasound scan which takes around 10-15 minutes.  The men are advised verbally of their result at this point.  If the result is less than 3cm (non-aneurysmal) the man is discharged from the screening programme and will not be sent a further appointment.  The GP will be notified of the result by letter

If an aneurysm is found over 3 cm, surveillance is offered either yearly or quarterly depending on size.  Any referral required will be from NAASP to the appropriate Service and the GP will be informed through electronic letter

Men who are over 65 and believe they have not been invited previously can contact their Local AAA screening service for advice Contact Telephone Number: 01482 675507.

Further information on the screening is available in the information for health professionals and patient leaflet AAA screening: information for health professionals - GOV.UK (www.gov.uk)  Abdominal aortic aneurysm screening: invitation leaflet - GOV.UK (www.gov.uk)

Occasionally aneurysms are found incidentally through scans for other conditions.  In these cases if a man over 65 years of age, please contact NAAASP in the first instance to discuss if the man is under NAAASP surveillance and for further information or referral guidance.

2) GP Referral - Routine

Unless emergent, i.e. Symptomatic AAA, referral from other services should be through the GP.

Women and men under 65 are not invited for screening by NAAASP. However high risk patients can be referred to the vascular department, such as men over 60 who have a family history of aneurysms

Diagnostic tests need to be run prior to a referral to any of the below to ascertain the size of the aneurysm

3) GP Referral Urgent AAA> 5.5cm

Urgent OPA

Perform CTa/CPEX/MUGA

3) GP Referral Urgent AAA> 5.5cm

Urgent OPA

Perform CTa/CPEX/MUGA

4) GP Referral - Urgent AAA> 7cm

Telephone Vascular Consultant for direct admission to HRI

5) Emergency AAA

Acute onset of back pain or collapse

Call 999

Vascular Departments

Hull Royal Infirmary switchboard: 01482 328541

Castle Hill switchboard: 01482 875875

Local AAA Screening Service

NHS Abdominal Aortic Aneurysm Screening Programme (NAAASP) - North Yorkshire and Humber. The service delivers screening in locations throughout the area. 

Contact Telephone Number: 01482 675507

AAA Guidance

AAA screening: information for health professionals - GOV.UK (www.gov.uk)

AAA Pathway

Abdominal aortic aneurysm screening: invitation leaflet - GOV.UK (www.gov.uk)