Breakthrough over medical timebomb that kills 20 a day

SCOTTISH scientists believe they have moved closer than ever before to understanding a common condition that can quickly kill patients.

A team from Edinburgh University has developed a new technique which can be used to diagnose those patients most at risk of dying from aortic aneurysms - balloon-like swellings in the body's main artery.

By identifying those in danger of potentially fatal complications, the scientists hope they will be able to prioritise people most in need of treatment and avoid unnecessary surgery in those at less risk.

Aortic aneurysms cause blood-filled swellings in the artery walls and if left untreated can rupture and cause massive internal bleeding and sudden death. The condition accounts for around 7,000 deaths a year in the UK - almost 20 a day - and affects more men than women.

The Edinburgh team was able to differentiate between the different types of aneurysm by injecting tiny particles of magnetic iron into the bloodstream of patients known to have an aneurysm. They then took images of the aorta using a powerful MRI scanner.

On the images the iron glowed red and orange in the parts of the aneurysms where immune cells were gathering. They knew that the higher the level of immune cells, the faster the aneurysms could grow and make them more likely to rupture soon.

When cells are active near the edge of the swelling it seems to make them more dangerous. - something which until now it has been impossible to measure.

The scientists found three different types of aortic aneurysm, with one of these shown to be particularly risky and in need of urgent treatment.

In future it could be possible that patients found to have an aneurysm through regular ultrasound screening could be offered this additional test to decide whether they needed surgery to fix the problem or could carry on with their lives without it.

Scotland is in the process of rolling out a screening programme for aortic aneurysm using ultrasound scans on men when they reach 65.

Dr Jenny Richards of the University of Edinburgh, who led the research, said: "Despite being a widespread, fatal disease, we know very little about what makes one case of abdominal aortic aneurysm more dangerous than another. Current techniques based only on the size of the swelling can't reliably tell you how much you are at risk.

"Patients and their families face an excruciating decision to opt for surgery once a diagnosis of abdominal aortic aneurysm is made. One in 20 of these operations is fatal, but if you put it off and your aneurysm ruptures, you have only a one in five chance of survival."Professor Peter Weissberg, medical director at the British Heart Foundation, who funded the research, said: "This preliminary study suggests that a magnetic resonance scan may be able to predict which patients are at greatest risk of a ruptured an-eurysm. If larger studies confirm these findings, this technique could become routine.

"We hope to work out who to prioritise for urgent treatment."