Ultrasound


Saving lives through ultrasound screening


Lives are saved every year in Scotland as a result of a major screening programme using advanced ultrasound imaging. CSJ provides an insight into the technology that is ensuring early detection of abdominal aortic aneurysms.


Mindray is working with NHS Scotland to help save the lives of men at risk of abdominal aortic aneurysm (AAA), through intelligent ultrasound screening technology. The aim of the AAA screening programme is to find aneurysms (bulges in blood vessels) early, and to monitor or treat them. As the wall of the aorta stretches, it becomes weaker and can rupture. When an aneurysm ruptures, less than half of patients will reach hospital alive and, even when an operation is possible, mortality is high – in fact, the overall chance of death from rupture is as high as 85%.1 However, early detection and treatment of


AAA greatly reduces the chance of rupture. In Scotland, overall uptake of the AAA screening programme is high – with 84% of men attending their appointment.2


A ‘Four Nations’ approach The screening programme was implemented in Scotland in line with the advice from the UK National Screening Committee (NSC). There was a phased roll-out of the programme from June 2012, as part of a ‘Four Nations approach’. NHS


Highland and NHS Western Isles were the first NHS Boards to roll out the national screening programme and, by November 2013, all NHS Boards were participating.1 “AAA can be deadly and often has no


symptoms. It is estimated that about 1 in 20 men aged 65 and over, in Scotland, have an abdominal aortic aneurysm. By helping to ensure early detection and treatment, Mindray’s technology is helping to prevent unnecessary deaths,” explained Emma Polgar, an Advanced Specialist Sonographer and Clinical Applications Specialist, at Mindray UK.


Men aged 65 living in Scotland are


automatically invited for a one-off ultrasound scan. This cohort is specifically targeted by the screening programme as men are six times more likely to have an abdominal aortic aneurysm than women.1


In addition to the risk factors of age and


sex, men are at higher risk if they are smokers, have high cholesterol, have high blood pressure and have a family history of aneurysms. The aorta is measured by taking the diameter


from the inner-to-inner walls. The measurement is taken in two anterior–posterior (AP) planes:


one with the probe in the longitudinal plane and one with the probe in the transverse plane. If the abdominal aorta is not enlarged (less


than 3cm) the individual will not need to be tested again. A small to medium aneurysm (between 3cm and 5.4cm) means the individual will need to be regularly monitored to check its growth. If a large aneurysm (5.5cm or bigger) is detected, the individual is referred to a specialist within two weeks who can advise on whether they would benefit from treatment to reduce the risk of the aneurysm bursting. If an aneurysm is detected, repair can be performed via open surgery, or by inserting a stent graft (endovascular aneurysm repair or EVAR) which is undertaken via minimally invasive surgery.


The project To measure the aorta, a scan is taken using a portable ultrasound machine. Mindray was previously chosen as one of two suppliers for the AAA screening programme in England. In Scotland, the tender strategy was focused on selecting a single supplier. Following a rigorous evaluation, the contract was awarded exclusively


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