Growth rates of small abdominal aortic aneurysms assessed by computerised tomography: a systematic literature review

Hendy, Kerolos, Gunnarsson, Ronny, and Golledge, Jonathan (2014) Growth rates of small abdominal aortic aneurysms assessed by computerised tomography: a systematic literature review. Atherosclerosis, 235 (1). pp. 182-188.

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Abstract

Background: Most current evidence examining abdominal aortic aneurysm (AAA) growth is based on ultrasound surveillance.

Objective: This review aimed to systematically analyse studies which have assessed small AAA growth using computed tomography (CT) to monitor outcome.

Method: Studies investigating small AAA expansion rates using CT images were identified by searching the PubMed database and hand searching article reference lists. Eligible studies must have focused on monitoring small AAA growth using CT and included patients with baseline AAA diameters <55 mm for which growth rates were reported.

Results: Ten studies including 845 patients met eligibility with average baseline AAA diameters ranging from 36.2 to 50.5 mm. AAA growth was assessed using axial (n = 1), orthogonal (n = 2), anterior to posterior (n = 4), and unspecified (n = 3) measurement methods. One study reported the reproducibility of their assessment method. Mean AAA diameter growth rates ranged from 2.6 to 5.2 mm/year. Factors reported to be associated with increased AAA expansion included: large AAA thrombus size (n = 3 studies), large baseline AAA diameter (n = 2), high AAA wall stress, elevated plasma concentration of matrix metalloproteinase-9 and presence of carotid artery disease (n = 1 study each). Factors reported to be negatively associated with AAA growth included presence of diabetes mellitus and chronic limb ischaemia (n = 1 study each).

Conclusion: Many currently reported studies assessing small AAA growth on CT fail to report consistent use of reproducible measurement methods. CT offers the opportunity to assess orthogonal diameter and perform central reading which could be an advantage of this form of imaging.

Item ID: 35463
Item Type: Article (Research - C1)
ISSN: 1879-1484
Keywords: abdominal aortic aneurysm; computer tomography; growth rate
Funders: National Health and Medical Research Council of Australia (NHMRC), Centre for Research Excellence (CRE), Office of Health and Medical Research, Queensland Government
Projects and Grants: NHMRC project grant 1063476, NHMRC project grant 1022752, NHMRC project grant 1021416, NHMRC project grant 1020955, NHMRC project grant 1003707, CRE grant 000967, CRE Fellowship 1019921, NHMRC Practitioner Fellowship 1019921, NHMRC Senior Clinical Research Fellowship
Date Deposited: 03 Mar 2015 04:11
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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