Operation Vesalius 2013 found that the rate of abdominal aortic aneurysm in men over 75 was 8%. Gold screening stops at this age.
The aneurysm is defined by an enlargement of the aorta, the edges are no longer parallel and the diameter is then increased by more than 50%. Today, screening for abdominal aortic aneurysm stops at age 75, according to recommendations. But for vascular medicine specialists, this limit is no longer in line with demographic trends. “More and more people are aging in good health, even beyond the age of 75, but we do not suspect in them the possibility of an aneurysm”, indicates Dr. Jean-Pierre Laroche, vascular doctor at the University Hospital of Montpellier , and vice president of the French College of vascular pathology.
Thus, when ” Operation Vesalius »Organized by the French Society of Vascular Medicine (SFMV), last November, which made it possible to screen more than 7,200 people, the doctors noted that the rate of aneurysm detected in more than 75 is of nearly 8%, while it is nearly 3% among 60-75 year olds. “This is an important figure, which prompts us to be vigilant beyond the age of 75. “.
Listen to Dr Jean-Pierre Laroche, vascular doctor at the Montpellier University Hospital, vice-president of the French College of vascular medicine. ” By limiting screening to age 75, we do not take into account the population which is in the process of aging. ”
Underrated women
Another criticism is the place of women in screening. So far the recommendations of the High Authority of Health (HAS) do not target them unless they have a family history. “It is true that the frequency of aneurysms of the abdominal aorta is 10 times lower in women than in men, but it should be known that aneurysms in women, on the other hand, have a more serious form, underlines the Dr Jean-Pierre Laroche. Another worrying point is the smoking of women. “Epidemiological studies show that they smoke almost as much as men, so there is no reason to leave them outside the recommendations for screening,” said the practitioner who calls on general practitioners to be vigilant.
If a small aneurysm is discovered, ultrasound follow-up is necessary. Aortic aneurysms increase in size slowly but surely, hence the need for this monitoring. For example, if the diameter of the aorta is between 45 and 50 mm, an ultrasound every 6 months will be necessary. In case of discovery of a large aneurysm, greater than or equal to 50/55 mm in diameter, the general practitioner then entrusts the patient to a medico-surgical team so that the patient is taken care of in the best conditions to treat this aneurysm. : direct surgery (prosthetic replacement of the aneurysmal aorta) or the placement of an aortic endoprosthesis via the femur may be solutions.
Listen to Dr Jean-Pierre Laroche. ” Smoking cessation is very important ”
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