Q M Ghulam1, K K Bredahl2, L Lönn3, L Rouet4, H H Sillesen5, J P Eiberg6. 1. Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Electronic address: http://twitter.com/@Rigshospitalet. 2. Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Denmark. 3. Department of Interventional Radiology, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. 4. Medisys, Philips Research, Suresnes, France. 5. Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. 6. Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Copenhagen Academy of Medical Education and Simulation, Capital Region of Denmark, Copenhagen, Denmark.
Abstract
OBJECTIVES: Rupture risk in abdominal aortic aneurysms (AAAs) is assessed using AAA diameter; yet 10% of ruptures occur in a small aneurysm. This underlines the inadequacy of diameter as a standalone parameter. In this prospective follow-up study, ultrasound determined aneurysm diameter was compared with aneurysm volume determined by three dimensional ultrasound (3D-US) in a group of 179 AAAs. DESIGN: This was a prospective cohort study with repeated diameter and volume measurements by 3D-US. MATERIAL AND METHODS: In total, 179 patients with small infrarenal AAAs (diameter 30-55 mm) were enrolled consecutively. At enrolment and at 12 month follow-up, maximum diameter, using dual plane technique, and three dimensional volume were measured. Based on a previous accuracy study, significant change in diameter and volume were defined as an increase exceeding the known range of variability (ROV) of each US technique; ±3.7 mm and ±8.8 mL, respectively. Post-hoc Kaplan-Meier analysis was performed to estimate time to conversion to treatment after the conclusion of the follow-up period between two groups. RESULTS: In total, 125 patients (70%) had an unchanged diameter during follow-up. In this group, 50 patients (40%) had an increasing aortic volume. Forty-five (83%) of the 54 patients with an increasing aortic diameter showed a corresponding volume increase. During a median follow-up of 367 days (364-380 days), a mean increase in diameter of 2.7 mm (±2.6 mm) and a mean increase in volume of 11.6 mL (±9.9 mL) were recorded. In post-hoc analysis, it was found that more AAAs with a stable diameter and a growing volume than AAAs with a stable diameter and volume were undergoing aortic repair during follow-up, based on the maximum diameter. CONCLUSION: In this cohort of small AAAs, 40% of patients with a stable diameter had an increasing volume at 12 month follow-up. From this perspective, 3D-US could have a future supplemental role in AAA surveillance programmes.
OBJECTIVES: Rupture risk in abdominal aortic aneurysms (AAAs) is assessed using AAA diameter; yet 10% of ruptures occur in a small aneurysm. This underlines the inadequacy of diameter as a standalone parameter. In this prospective follow-up study, ultrasound determined aneurysm diameter was compared with aneurysm volume determined by three dimensional ultrasound (3D-US) in a group of 179 AAAs. DESIGN: This was a prospective cohort study with repeated diameter and volume measurements by 3D-US. MATERIAL AND METHODS: In total, 179 patients with small infrarenal AAAs (diameter 30-55 mm) were enrolled consecutively. At enrolment and at 12 month follow-up, maximum diameter, using dual plane technique, and three dimensional volume were measured. Based on a previous accuracy study, significant change in diameter and volume were defined as an increase exceeding the known range of variability (ROV) of each US technique; ±3.7 mm and ±8.8 mL, respectively. Post-hoc Kaplan-Meier analysis was performed to estimate time to conversion to treatment after the conclusion of the follow-up period between two groups. RESULTS: In total, 125 patients (70%) had an unchanged diameter during follow-up. In this group, 50 patients (40%) had an increasing aortic volume. Forty-five (83%) of the 54 patients with an increasing aortic diameter showed a corresponding volume increase. During a median follow-up of 367 days (364-380 days), a mean increase in diameter of 2.7 mm (±2.6 mm) and a mean increase in volume of 11.6 mL (±9.9 mL) were recorded. In post-hoc analysis, it was found that more AAAs with a stable diameter and a growing volume than AAAs with a stable diameter and volume were undergoing aortic repair during follow-up, based on the maximum diameter. CONCLUSION: In this cohort of small AAAs, 40% of patients with a stable diameter had an increasing volume at 12 month follow-up. From this perspective, 3D-US could have a future supplemental role in AAA surveillance programmes.
Authors: Nahla Ibrahim; Sonja Bleichert; Johannes Klopf; Gabriel Kurzreiter; Viktoria Knöbl; Hubert Hayden; Albert Busch; Alexander Stiglbauer-Tscholakoff; Wolf Eilenberg; Christoph Neumayer; Marc A Bailey; Christine Brostjan Journal: Front Cardiovasc Med Date: 2022-07-12
Authors: Moritz Lindquist Liljeqvist; Marko Bogdanovic; Antti Siika; T Christian Gasser; Rebecka Hultgren; Joy Roy Journal: Sci Rep Date: 2021-09-10 Impact factor: 4.379