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This editorial refers to ‘Evaluation of the diagnostic and prognostic value of plasma D-dimer for abdominal aortic aneurysm’[†][1], by J. Golledge et al. on page 354 Over the last decade, abdominal aortic aneurysm (AAA), defined as an aortic diameter ≥30 mm, has increasingly been recognized as an important cause of mortality, accounting for 2.1% of deaths in men aged >65 years. Large screening studies have suggested a prevalence of 5.1–7.7% in men over the age of 64. Despite advances in surgical and anaesthesiological techniques, mortality remains high in patients with a ruptured AAA. Thus, elective repair in appropriately selected individuals is advantageous, prevents rupture, and thereby improves life expectancy. Simplified abdominal ultrasound is recognized for its accuracy in identifying AAA, with a reported sensitivity of 95% and specificity of 99%. Evidence suggests that a single screening in the highest risk group is sufficient to exclude risk from this disease for >10 years with <2% of examinations insufficient to measure aortic diameters.1Based on these data, ultrasound screening programmes have been evaluated in an attempt to reduce AAA-related mortality in the general population. The largest of these trials, the Multicentre Aneurysm Screening Study, randomized a population-based sample of 67 800 men aged 65–74 years in the UK. After 4 years of follow-up, relative risk reduction of AAA-related deaths was 42% [95% confidence interval (CI) 22–58%].2 A meta-analysis of further randomized controlled trials subsequently confirmed these results [odds ratio (OR) in AAA-related mortality, 0.56; 95% CI 0.44–0.72]. Moreover, long-term results showed a significant reduction in emergency operations (OR 0.48; 95% CI 0.28–0.83), while the number of elective operations increased significantly (OR 2.81; … [1]: #fn-2

D-dimer measurement: a useful prognostic marker in surveillance of patients with abdominal aortic aneurysm?