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• W4245433602 abstract "Introduction - Rupture risk in abdominal aortic aneurysms (AAAs) is assessed from the AAA’s diameter (1-5); yet, every tenth rupture case occurs in a small aneurysm (1,6-9). This underlines the inadequacy of the diameter as a stand-alone 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 AAA patients. Methods - From the outpatient clinic, 179 patients with small asymptomatic infra-renal AAAs (diameter 30-55 mm) were enrolled consecutively. At enrolment and at a 12-month follow-up, the maximal diameter was measured on-cart using dual-plane technique and off-line three-dimensional volume quantification, with semi-automated software. Based on a previous accuracy study, growth 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. Results - In total, 125 patients (70%) had an unchanged diameter during follow-up (Table 1). In this “stable diameter” group, 50 patients (40%) had an increasing aortic volume. Forty-five (83%) of the 54 patients with an increasing aortic diameter during follow-up showed a corresponding volume increase (Figure 1). During a median follow-up of 367 days (364-380 days), we recorded 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). In a post-hoc analysis, we 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.Table 1Two by two contingency table displaying the distribution between aortic diameter and volume changes, as nominal outcome according to the range of variabilityVolumeDiameterStableGrowthTotalStable7550125Growth94554Total8495179 Open table in a new tab Conclusion - In this cohort of small AAAs, 40% of patients with a stable diameter had an increasing volume at the 12-month follow-up. In this perspective, 3D-US could have a future supplemental role in AAA surveillance programmes. References1)Powell JT, Brown LC, Forbes JF, Fowkes FGR, Greenhalgh RM, Ruckley C V., et al. Final 12-year follow-up of surgery versus surveillance in the UK Small Aneurysm Trial. Br J Surg. 2007 Jun;94(6):702–8.2)Lederle FA, Wilson SE, Johnson GR, Reinke DB, Littooy FN, Acher CW, et al. Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002 May 9;346(19):1437–44.3)Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D, et al. Prevalence and associations of abdominal aortic aneurysm detected through screening. Ann Intern Med. 1997 Mar 15;126(6):441–9.4)Filardo G, Lederle F a, Ballard DJ, Hamilton C, da Graca B, Herrin J, et al. Immediate open repair vs surveillance in patients with small abdominal aortic aneurysms: survival differences by aneurysm size. Mayo Clin Proc. 2013 Sep;88(9):910–9.5)Skibba AA, Evans JR, Hopkins SP, Yoon HR, Katras T, Kalbfleisch JH, et al. Reconsidering gender relative to risk of rupture in the contemporary management of abdominal aortic aneurysms. J Vasc Surg. 2015;62(6):1429–36.6)Nicholls SC, Gardner JB, Meissner MH, Johansen KH. Rupture in small abdominal aortic aneurysms. J Vasc Surg. 1998;28(5):884–8.7)Kontopodis N, Pantidis D, Dedes A, Daskalakis N, Ioannou C V. The - Not So - Solid 5.5 cm Threshold for Abdominal Aortic Aneurysm Repair: Facts, Misinterpretations, and Future Directions. Front Surg. 2016;3(January):1.8)Laine MT, Vänttinen T, Kantonen I, Halmesmäki K, Weselius EM, Laukontaus S, et al. Rupture of Abdominal Aortic Aneurysms in Patients Under Screening Age and Elective Repair Threshold. Eur J Vasc Endovasc Surg. 2016;51(4):511–6.9)Darling RC, Messina CR, Brewster DC, Ottinger LW. Autopsy study of unoperated abdominal aortic aneurysms. The case for early resection. Circulation. 1977 Sep;56(3 Suppl):II161-4." @default.
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• W4245433602 date "2019-12-01" @default.
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• W4245433602 title "Follow-Up on Small Abdominal Aortic Aneurysms Using Three-Dimensional Ultrasound: Volume Versus Diameter" @default.
• W4245433602 doi "https://doi.org/10.1016/j.ejvs.2019.06.681" @default.
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