1. Dr. Phil O’Halloran Surgical Grand Rounds

2. Case. HS 65 year old male electively admitted for an EVAR on the. Pilot Screening programme AAA Size (cm) = 5.62

3. Case. BKGD: Nil of significance. Meds: NKDA Smoker : 10/day 40 years. Pre-op Work up: Echo - EF 55% Underwent endurant bifuracted repair of AAA. Lipitor 10mg od po PFT’s: Normal

4. Post Op Transfer back to Ward. Normal bloods day 1 post-op. Eating and Drinking. Mobilizing. Discharged well.

5. AAA Screening. Should we be doing it?

6. AAA Screening NHS Abdominal Aortic Aneurysm Screening Programme

7. AAA Screening - Why? 8:1 4% of men aged 65-74. Significant Morbidity & Mortality. Vascular Disease = 40% of UK deaths. Family History. Smoking / Hypertension.

8. AAA Screening

9. Lancet 2002; Nov 16; 360 (9345): 1531-9.

10. MASS Study

12. 42% reduction of risk in the invited group. Similar mortality rate in those who DNA and control group. Substantial benefit of AAA Screening (P value: 0.0002)

13. . Cosford PA, Leng GC. Screening for abdominal aortic aneurysm. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD002945. DOI: 10.1002/14651858.CD002945.pub2.

14. Making the Case for Cardiovascular Screening in Irish Males: Detection of Abdominal Aortic Aneurysms, and Assessment of Cardiovascular Risk Factors M. Brosnan b, C.G. Collins a, D.S. Moneley a, C.J. Kelly a,b, A.L. Leahy a,b,* a Department of Surgery, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin 9, Ireland b Department of Vascular Diagnostic Unit, Connolly Hospital, Blanchardstown, Dublin 15, Ireland Eur J Vasc Endovasc Surg (2009) 37, 300e304

15. Irish Pilot Study. April 2006 - Decemeber 2007. Males 55-75 invited for screening. GP register (N = 1414) 904 accepted: 568 (63%) aged 55-64 336 (37%) aged 64-75

16. Irish Pilot Study. 17/904 ( 1.9%) previously undiagnosed aneurysm detected. Sizes ranging from 3-5.8cm 0.6% in 55-64 age group. 4.2% in 65-75 age group (p<0.01) Conclusion AAA screening in 65-75 age group in Ireland is justified.