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Abdominal Aortic AneurysmNOR-AORTANCT06403423

Screening for Aortic Aneurysms in Inland Norway

An observational study of Abdominal Aortic Aneurysm and Erectile Dysfunction, run by Sykehuset Innlandet HF at 1 site in Norway.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

The number of AAA-surgeries performed per capita is 3-4 times higher in Innlandet county, as compared to Oslo. The last three years the annual incidence of AAA requiring treatment has been 21.5 / 100 000 inhabitants in Innlandet, as compared to 6.6 / 100 000 in Oslo. Read more about this study

Who is it for?
Ages 65 to 65 years, men onlyHealthy volunteers can take part
How many people
240 participants
Where
1 siteNorway
Study dates
14 May 2024to 31 Dec 2030
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 to 65 years
  • Men only
  • Healthy volunteers accepted
  • Older adult

Study population: All men in Innland Norway

Who may be able to join

  • All men in Inland Norway are invited

Who cannot join

  • unwilling or unable to concent

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Norway1 site
  • Sykehuset Innlandet

    Hamar, Hamar

Other trials in Norway

About this study

Official title: Screening for Infra-renal Abdominal Aortic Aneurysms in 65-year-old Men in Inland, Norway

The number of AAA-surgeries performed per capita is 3-4 times higher in Innlandet county, as compared to Oslo. The last three years the annual incidence of AAA requiring treatment has been 21.5 / 100 000 inhabitants in Innlandet, as compared to 6.6 / 100 000 in Oslo. The indication for surgery is the same in both regions. In Oslo, a screening program was established in 2011, reporting a prevalence of AAA of 2.6 %, but in Innlandet county all AAA are either symptomatic or incidental findings and the prevalence is unknown. The aetiology of the major difference in AAA prevalence between these two regions has not been previously explored.

Read the detailed description

Abdominal aortic aneurysm (AAA) is a dilatation of the main artery from the heart as it passes through the abdomen. In case of rupture, the condition is life threatening and acute surgery is required. The prevalence of AAA is four to six times higher in men as compared to women, and varies greatly between countries and regions, but is generally reported to be present in 1.5-5% of men. Over the last three decades, the prevalence of AAA has been relatively stable, despite improved medical therapy for cardiovascular disease and a declining use of tobacco in Norway and comparable countries. This may in part be a consequence of unchanged aneurysmal progression rate combined with improved life expectancy of individuals at risk of developing AAA. Approximately 1% of all deaths in men over 65 years of age in Norway is caused by a ruptured AAA. The mortality is 75-80% after rupture, and half the patients die before they reach a hospital with vascular surgery. A patient with an incidental finding of AAA will be offered surgery in an elective setting to prevent rupture. The number of AAA surgeries in Norway was 851 in 2021 according to the Norwegian Vascular Surgery Registry (NORKAR).

The key challenge in improvement of aneurysm related mortality is to detect the disease while it is still asymptomatic. Screening is required to detect an asymptomatic AAA and is considered a beneficial healthcare intervention in several European countries.

We hypothesize that the prevalence of AAA is significantly higher in Innlandet, as compared to Oslo, and further, that the discrepancies in AAA prevalence between regions may be caused by differences in prevalence of risk factors, medication, socio-economic status, or in variations in genetic susceptibility.

Several genetic markers and other biomarkers have been proposed to relate to aneurysm disease. Of the clinically applicable biomarkers D-dimer, LDL cholesterol, HDL cholesterol, Thrombocytes, Apolipoprotein B and HbA1c have been found to have the most significant association to aneurysm growth rate. Studies on biomarkers for AAA have been hampered by low number of patients and currently no specific biomarker has been identified as a tool to identify patients with AAA or to predict aneurysm growth and studies on larger populations of patients with AAA have been called for.

The number of AAA-surgeries performed per capita is 3-4 times higher in Innlandet county, as compared to Oslo. The last three years the annual incidence of AAA requiring treatment has been 21.5 / 100 000 inhabitants in Innlandet, as compared to 6.6 / 100 000 in Oslo. The indication for surgery is the same in both regions. In Oslo, a screening program was established in 2011, reporting a prevalence of AAA of 2.6 %, but in Innlandet county all AAA are either symptomatic or incidental findings and the prevalence is unknown. The aetiology of the major difference in AAA prevalence between these two regions has not been previously explored.

There is some data on the psychological impact of a AAA screening and how a screening may impact the quality of life in patients diagnosed with AAA. However, there are still uncertainties towards the potential psychological harm of AAA screening, and further studies are required. Additionally, patients with AAA have in small studies an 80% reported prevalence of moderate to severe erectile dysfunction which is significantly higher than in the general population. Erectile dysfunction is also found to have an impact on the individual's quality of life, but the data on erectile dysfunction in AAA patients is limited.

Only men are included in the study. A prevalence of ≥1.5% is considered the cut-off for cost-benefit for screening for AAA. Previous studies have concluded that screening of women is not clinically indicated or cost-effective. Evaluation of recent data from the Norwegian Vascular Surgery registry has shown a stable proportion of women treated for AAA in Innlandet over several years. Consequently, women will not be incorporated into the study.

Medical subject headings
Aortic Aneurysm, Abdominal, Erectile Dysfunction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT06403423
Study groupRoleWhat they receive
Patients with AAA65-year old men in Inland, Norway will be invited by mail to a screening. Patients with detected aneurysm will be followed over time with blood samples and questionnaires in addition to ultrasound measurement of the diameter of the infrarenal abdominal aortic aneurysm.
Control group (no AAA)65-year old men in Inland, Norway will be invited by mail to a screening. A matched group of individuals without AAA will be included as control patients and followed with blood samples and questionnaires.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Prevalence

    Prevalence of AAA is examined by screening of all 65 year old men in Innland, Norway during a period of three years. Screening is performed by ultrasound measurement of AP outer-outer diameter.

    Measured: 3 years

  2. Etiology

    Etiology of the anticipated high prevalence of AAA is explored through questionnaires and blood samples. Baseline charactereristics is to be compared to a different region in Norway with a similar screening project, and to be compared with control patients.

    Measured: 3 years

Secondary outcomes (5)
  1. Aneurysm related mortality

    The norwegian cause of death registry will be consulted to find aneurysm related mortality in the region before, during and after introduction of the screening program.

    Measured: 6 years

  2. All cause mortality

    The norwegian cause of death registry will be consulted to find aneurysm related mortality and all cause mortality in the region before, during and after introduction of the screening program.

    Measured: 6 years

  3. Prevalence of peripheral arterial insufficiency

    Ankle brachial index will be measured in all patients. Ankle brachial index is a the measure of systolic blood pressure in the arm compared to the systolic blood pressure at the ankle. A normal ABI is 0,9-1,2, ranging from 0-1,5 (over 1,5 = incompressible vessels)

    Measured: 3 years

  4. Prevalence of erectile dysfunction

    Patients will be asked to fill out IIEF (erectile function questionnaire) to evaluate the prevalence and degree of erectile dysfunction in Inland Norway. 5 questions, each ranging from 1-5.

    Measured: 3 years

  5. Quality of Life following screening

    Effect of screening on qol are measured with SF-36 at baseline, 6 months and one year. A score from 0-100 is obtained through the questionnaire.

    Measured: 6 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 May 2024
  2. Study start14 May 2024
  3. Primary completion9 May 2027 (estimated)
  4. Study completion31 Dec 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
240 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06403423
Sponsor's protocol ID
SI-150503
Acronym
NOR-AORTA
Status last verified
May 2025
First submitted
26 Apr 2024
Last updated
16 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T, Dick F, van Herwaarden J, Karkos C, Koelemay M, Kolbel T, Loftus I, Mani K, Melissano G, Powell J, Szeberin Z, Esvs Guidelines Committee, de Borst GJ, Chakfe N, Debus S, Hinchliffe R, Kakkos S, Koncar I, Kolh P, Lindholt JS, de Vega M, Vermassen F, Document Reviewers, Bjorck M, Cheng S, Dalman R, Davidovic L, Donas K, Earnshaw J, Eckstein HH, Golledge J, Haulon S, Mastracci T, Naylor R, Ricco JB, Verhagen H. Editor's Choice - European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2019 Jan;57(1):8-93. doi: 10.1016/j.ejvs.2018.09.020. Epub 2018 Dec 5. No abstract available.

    PubMed 30528142
  • Altreuther M. NORKAR Årsrapport for 2021 med plan for forbedringstiltak. St. Olavs Hospital; 2022.

  • Lindholt JS, Diederichsen AC, Rasmussen LM, Frost L, Steffensen FH, Lambrechtsen J, Urbonaviciene G, Busk M, Egstrup K, Kristensen KL, Behr Andersen C, Sogaard R. Survival, Prevalence, Progression and Repair of Abdominal Aortic Aneurysms: Results from Three Randomised Controlled Screening Trials Over Three Decades. Clin Epidemiol. 2020 Jan 23;12:95-103. doi: 10.2147/CLEP.S238502. eCollection 2020.

    PubMed 32158272
  • Frønsdal KB, Svensjö S, Movik E, Desser AS, Smedslund G. Abdominalt aortaaneurisme (AAA) screening av menn i alder 65 år. 2020.

  • Rabben T, Mansoor SM, Bay D, Sundhagen JO, Guevara C, Jorgensen JJ. Screening for Abdominal Aortic Aneurysms and Risk Factors in 65-Year-Old Men in Oslo, Norway. Vasc Health Risk Manag. 2021 Sep 10;17:561-570. doi: 10.2147/VHRM.S310358. eCollection 2021.

    PubMed 34531660
  • Ali MU, Fitzpatrick-Lewis D, Kenny M, Miller J, Raina P, Sherifali D. A systematic review of short-term vs long-term effectiveness of one-time abdominal aortic aneurysm screening in men with ultrasound. J Vasc Surg. 2018 Aug;68(2):612-623. doi: 10.1016/j.jvs.2018.03.411.

    PubMed 30037679
  • Nana P, Dakis K, Brodis A, Spanos K, Kouvelos G. Circulating Biomarkers for the Prediction of Abdominal Aortic Aneurysm Growth. J Clin Med. 2021 Apr 16;10(8):1718. doi: 10.3390/jcm10081718.

    PubMed 33923412
  • Lyttkens L, Wanhainen A, Svensjo S, Hultgren R, Bjorck M, Jangland E. Systematic Review and Meta-Analysis of Health Related Quality of Life and Reported Experiences in Patients With Abdominal Aortic Aneurysm Under Ultrasound Surveillance. Eur J Vasc Endovasc Surg. 2020 Mar;59(3):420-427. doi: 10.1016/j.ejvs.2019.07.021. Epub 2020 Jan 10.

    PubMed 31928908
  • Ericsson A, Kumlien C, Ching S, Carlson E, Molassiotis A. Impact on Quality of Life of Men with Screening-Detected Abdominal Aortic Aneurysms Attending Regular Follow ups: A Narrative Literature Review. Eur J Vasc Endovasc Surg. 2019 Apr;57(4):589-596. doi: 10.1016/j.ejvs.2018.10.012. Epub 2019 Mar 22.

    PubMed 30910494
  • Falkensammer J, Hakaim AG, Falkensammer CE, Broderick GA, Crook JE, Heckman MG, Oldenburg WA, Hugl B. Prevalence of erectile dysfunction in vascular surgery patients. Vasc Med. 2007 Feb;12(1):17-22. doi: 10.1177/1358863X06076043.

    PubMed 17451089
  • Elterman DS, Bhattacharyya SK, Mafilios M, Woodward E, Nitschelm K, Burnett AL. The Quality of Life and Economic Burden of Erectile Dysfunction. Res Rep Urol. 2021 Feb 18;13:79-86. doi: 10.2147/RRU.S283097. eCollection 2021.

    PubMed 33634039
  • Scott RA, Bridgewater SG, Ashton HA. Randomized clinical trial of screening for abdominal aortic aneurysm in women. Br J Surg. 2002 Mar;89(3):283-5. doi: 10.1046/j.0007-1323.2001.02014.x.

    PubMed 11872050
  • Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999 Dec;11(6):319-26. doi: 10.1038/sj.ijir.3900472.

    PubMed 10637462
  • Bath MF, Sidloff D, Saratzis A, Bown MJ; UK Aneurysm Growth Study investigators. Impact of abdominal aortic aneurysm screening on quality of life. Br J Surg. 2018 Feb;105(3):203-208. doi: 10.1002/bjs.10721.

    PubMed 29405273

Questions about this trial

What is this clinical trial studying?

An observational study of Abdominal Aortic Aneurysm and Erectile Dysfunction, run by Sykehuset Innlandet HF at 1 site in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 16 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prevalence (time frame: 3 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06403423, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 May 2025.

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