The SAAAVE Act and Routine Ambulatory Medical Care Fail to Diagnose Patients with Abdominal Aortic Aneurysms prior to Rupture: A Single-Institution Experience

Objectives. To demonstrate that routine ambulatory medical evaluation in the outpatient setting and current utilization of the Screening Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act are inadequate methods to diagnose abdominal aortic aneurysms (AAA) prior to rupture. Methods. A retrospective review was performed on patients with ruptured AAA (rAAA) at a single institution. All patients who were evaluated in an ambulatory care setting within 6 months of the date of rupture were identified, and clinical data were analyzed. Results. Between January 1, 2004 and December 31, 2010, there were 149 patients with rAAA. Fifty-two of 149 (34.9%) patients were evaluated in the outpatient setting within 6 months prior to the date of rupture, and these patients form the basis of this study. Thirty-six of 52 (70%) patients were male, average age was 73.5 years, average BMI was 28, and average aneurysm diameter was 76 mm. Only 5/52 (9.6%) patients had physical exam findings suspicious for AAA. Only 9/52 (17%) would have been eligible for the screening abdominal ultrasound under the SAAAVE Act. Conclusions. Routine medical evaluation in the ambulatory care setting and current utilization of AAA screening methods are inadequate at detecting AAA in the at-risk population prior to rupture.