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E ARLY DE TECTION IMPROVES OUTCOMES. THIS IS TRUE FOR ALL DISE A SES. FOR ABDOMINAL AORTIC ANEURYSM ¥A A A¦, E ARLY DE TECTION SAVES LIVES. A A A, HOWE VER, IS USUALLY A SYMPTOMATIC. WHEN IT IS DISCOVERED, IT'S USUALLY BY ACCIDENT ¨ DURING DIAGNOSTIC IMAGING FOR GA STROINTESTINAL PROBLEMS, FOR E X AMPLE. Akron General Cardiac Thoracic & Vascular Surgery vascular specialists include (L-R) Loren Masterson, MD; Jill Zink, MD; Dennis J. Wright, MD; and Robert G. Netzley, MD. 1 4❱❱❱❱❱ S U R G E R Y S P O T L I G H T at Cleveland Clinic Akron General BY ROBERT JANEK Advances in AAA Repair FOR THE PA ST nine years one-time u lt ra sou nd screen i n g for A A A ha s been covered through the Screening Abdomina l Aor tic A neur ysms Ver y E«ciently (SAAAVE) Act for new male Medicare enrollees who have ever smoked. In 2014, the U.S. Preventive Services Task Force issued a statement recommending one-time screening for AAA by ultraso- nography in men ages 65 to 75 who have ever smoked, meaning they have smoked at least 100 cigarettes in their lifetime. For men in that same age bracket who have never smoked, the Task Force recommends that clinicians selectively oŸer screening. Jill Zink, MD, and Loren Masterson, MD, are fellowship-trained vascular surgeons who diagnose and treat AAA at Cleveland Clinic A kron Genera l. They feel the SA A AVE Act and the Task Force rec- ommendations don't go far enough. The Society for Vascular Surgeons (SVS), of which both doctors are members, agrees. "The Task Force and SA A AVE Act advocate screening in men, but not in women, because men are five times more likely to have abdominal aortic aneurysms than women," Dr. Zink explains. "SVS recommends screening for women over the age of 65 if they have a family history of aneurysms or if they have ever smoked," says Dr. Masterson. "The Society also recommends AAA screening for men with a family history of aneurysm starting a little earlier, at the age of 55." Approximately 200,000 people in the United States are diagnosed with AAA each year, and almost 15,000 die from it, according to SVS. Heart and vascular diseases, including high blood pressure and high cholesterol, increase risk, as does tobacco use. In fact, according to the CDC, people who smoke are three to five times more likely to develop AAA. Once A A A is detected, treatment is determined according to the size of the aneurysm. If the diameter is smaller than 5 centimeters, watchful waiting with ultrasonography or CT scan every six to 12 months is the norm. If the aneurysm is larger than that, or is growing quickly, surgery may be recommended. Open surgery involves a large midline incision, generally from the sternum almost to the pubic bone. The procedure lasts several hours. Afterwards, the patient is in the ICU for a couple of days and then in the hospital for at least a week. Full recovery takes from several weeks to several months. Dr. Masterson points out that some patients with other heart and/or lung diseases are not candidates for this PHOTO COURTESY OF CLEVELAND CLINIC AKRON GENERAL 1 4