Aneurysms: A Deeper Look at Screening Guidelines, Who Should Get Tested, and When

Why Aneurysms Require Special Attention

An aneurysm is a weakened, bulging area in the wall of a blood vessel. While it may remain stable for years, an aneurysm can become life-threatening if it ruptures, leading to severe internal bleeding or stroke.

What makes aneurysms particularly dangerous is that most cause no symptoms until a complication occurs. Many people feel completely well, sometimes right up to the moment of rupture.

That’s why early detection through appropriate screening is so important. Identifying an aneurysm before it causes harm allows for close monitoring, risk reduction, and when needed timely, often less invasive treatment.

Types of Aneurysms

Not all aneurysms behave the same way. Risks and screening recommendations depend largely on where the aneurysm occurs.

Cerebral (Brain) Aneurysms
These develop in the blood vessels supplying the brain. Many remain small and never rupture, but when rupture occurs it can cause a subarachnoid hemorrhage, a serious and potentially fatal form of stroke.

Because symptoms may be absent until rupture, screening is usually reserved for people with higher-than-average risk.

Abdominal Aortic Aneurysms (AAA)
Abdominal Aortic Aneurysms (AAA) is the most common aneurysm, especially among older adults and people with a history of smoking. It forms in the abdominal portion of the aorta and often grows slowly and silently over time.

Routine screening has been shown to significantly reduce aneurysm-related deaths.

Other, Less Common Aneurysms
These include:

• Thoracic aortic aneurysms (in the chest)
• Peripheral aneurysms (affecting arteries in the legs, arms, or neck)

While less common, these aneurysms can still pose serious risks if undetected.

Risk Factors: Who Is More Likely to Develop an Aneurysm?

Non-Modifiable Risk Factors

• Increasing age
• Family history of aneurysms
• Genetic or connective tissue disorders (e.g., Marfan syndrome)

Modifiable Risk Factors

• Smoking
• High blood pressure
• Atherosclerosis (plaque buildup in arteries)

Gender Differences
Abdominal aortic aneurysms occur more frequently in men. However, women who develop aneurysms often have a higher risk of rupture, making timely screening and follow-up especially important.

What Does Aneurysm Screening Mean?

Screening involves testing people who do not have symptoms, with the goal of detecting aneurysms early. This is different from diagnostic testing, which is done after symptoms appear.

Because aneurysms often remain silent, screening plays a key role in:

• Preventing rupture
• Planning early intervention
• Improving long-term outcomes

Screening Tests: What to Expect

Ultrasound

• Commonly used for Abdominal Aortic Aneurysms (AAA) screening
• Quick, painless, and non-invasive
• No radiation exposure
• Highly accurate for measuring aneurysm size

CT Angiography (CTA)

• Uses X-ray imaging with contrast dye
• Provides detailed images of blood vessels
• Often used for treatment planning or follow-up
• Often the test of choice for detecting Thoracic Aortic Aneurysm (TAA)

MRI / MR Angiography (MRA)

• Uses magnetic fields instead of radiation
• Commonly used for brain aneurysm screening
• Offers excellent detail of blood vessels

Your doctor will choose the most appropriate test based on risk factors, location of concern, and medical history.

Current Screening Guidelines

Cerebral (Brain) Aneurysm Screening
Screening may be considered for individuals with:

• A strong family history of brain aneurysms
• Genetic conditions such as polycystic kidney disease
• A prior history of brain hemorrhage

Common tests: MRI or MRA; sometimes CTA

Abdominal Aortic Aneurysm (AAA) Screening
Screening is recommended for:

• Men aged 65–75 who have ever smoked
• Selected high-risk women, particularly those with a smoking or family history

Preferred test: One-time abdominal ultrasound

Other Aneurysm Screening

• Thoracic aneurysm screening may be advised for people with inherited vascular conditions
• Peripheral aneurysm screening is usually guided by symptoms or the presence of other vascular disease

When Should You Get Tested?

Symptoms That Require Immediate Medical Attention

• Sudden, severe headache
• Unexplained abdominal or back pain
• A pulsating mass in the abdomen
• New neurological symptoms (weakness, speech difficulty, vision changes)

Routine Screening Considerations

• Reaching recommended age thresholds
• Personal or family history of aneurysm
• Long-term smoking or poorly controlled blood pressure

Key Candidates for Screening

• Men aged 65–75 with a history of smoking should undergo a one-time AAA ultrasound
• Individuals with a family history of brain aneurysms should consider screening imaging
• Anyone with warning symptoms should seek immediate medical evaluation

Why Choose RIVEA?

At RIVEA, aneurysm care is guided by precision, experience, and patient safety. Our multidisciplinary team combines advanced imaging, minimally invasive treatment options, and personalized care plans.

Patients trust RIVEA as one of the best hospitals for vascular problems, supported by some of the best vascular doctors experienced in aneurysm screening, monitoring, and treatment from early detection through long-term follow-up.

RIVEA is co-founded and led by Dr. Karthik Mikkineni, a U.S.-trained Chief Vascular Specialist with advanced expertise in endovascular aortic repair (EVAR) and Fenestrated EVAR (FEVAR). His specialized training and experience place RIVEA at the forefront of minimally invasive aortic aneurysm care, particularly for complex and high-risk cases.

The vascular department is further strengthened by Dr. Syed Mohammed Ali Ahmed, who is widely recognized for his work in aortic aneurysm and aortic occlusive disease. He offers a full spectrum of care, including both open surgical and endovascular treatments, ensuring that each patient receives a solution tailored to their condition, anatomy, and long-term health goals.