Reply to “Controversies in screening for abdominal aortic aneurysm”

Abstract

Thank you for your comments on our study [1]. We emphasize the need to prioritize a study on high risk population, particularly in countries where screening programmes for abdominal aortic aneurysm (AAA) have yet to be implemented. The possibility of overdiagnosis due to AAA screening is a complex one, in which both medical and surgical factors have to be taken into account. The main cause of death among patients with AAA is myocardial infarction [2]. Diagnosing an AAA justifies intervention and the usual measures for secondary prevention, which offers and improved opportunity for medical control on 3 fronts: preventing cardiovascular events, limiting the growth of the AAA and preparing the patient to reduce the risk of surgical intervention [3]. Repercussions on cardiovascular death could clear up many of the existing controversies. In high risk population, such as the patients who attend consultation with the cardiologist, the prevailing AAA is high and the risk of rupture is higher. In our study, 1.1% of the patients had AAA ≥ 5.5 cm and 1.5% an AAA of between 4.5 and 5.4 cm. The application of the score proposed based on risk factors, allows the selection of those patients with a higher risk of suffering on AAA being referred to cardiology and we hope it will prove to be a useful tool to reduce the mortality rate in our patients related to AAA [1].