Decreases in Diameters of Treated Abdominal Aortic Aneurysms and Reduction in Rupture Rate

Abstract

To determine whether the diameters of treated abdominal aortic aneurysms (AAAs) have changed during the last 10 years. Design, Setting, and Patients: A retrospective record review was completed on all patients undergoing any AAA repair from January 1, 2000, through December 31, 2009, at a single high-volume institution. All cases of repaired AAAs that had computed tomographic scans within 3 months of surgery were included. The mean and median maximal diameters of AAAs were noted. Correlation and regression analyses were used. Main Outcome Measures: The mean and median maximal diameters of AAAs. Results: Of 360 patients with treated AAAs, 339 met the inclusion criteria. The mean (SD) diameter of repaired AAAs decreased from 6.49 (1.46) cm (median, 6.40 cm) in 2000 to 5.83 (1.23) cm (median, 5.60 cm) in 2009. Correlation analysis confirmed a decrease in diameter across years (Pearson R=−0.141; P=.01). A fitted regression line also showed a decreasing trend (slope=−0.059 cm per year; P=.01). Conclusions: The diameters of repaired AAAs at our hospital have decreased progressively during the last decade. This observation is consistent with a reduction in the expansion rates of AAAs and may account for the progressive decreases in the aneurysm rupture rate in the United States.

Epidemiology of ruptured abdominal aortic aneurysms in a well-defined Norwegian population with trends in incidence, intervention rate, and mortality

“…Although the mortality from rAAA remains high, some reports suggest a decline in the rates of rAAA, 4,5 although the exact degree of decline and its contributing factors remain unclear. 4,[8][9][10] Epidemiologic data on rAAA are scarce; most studies are derived from poorly defined populations, are based on tertiary referral patterns or administrative data, or strictly focus on in-hospital patients. Notably, a large proportion of data stems from outdated time periods not representative of current population demographics, diagnostic abilities, and treatment methods.…”

Assessing Abdominal Aortic Aneurysm Progression by Using Perivascular Adipose Tissue Attenuation on Computed Tomography Angiography

“…The maximum AAA diameter is the most common measurement used to predict the risk of AAA rupture. Previous studies have determined AAA diameter to be an independent predictor of AAA progression and rupture [ 4 5 18 ]. This is consistent with the findings of our study, where maximal diameter (adjusted HR = 1.11; 95% CI, 1.04–1.19; P = 0.001) was an independent predictor of AAA progression.…”

“…Clinically, the maximum diameter of AAA, which is widely accepted as the main parameter for predicting AAA progression [ 4 5 ], can be detected by computed tomography angiography (CTA), abdominal and pelvic ultrasonography, and magnetic resonance imaging. However, using maximum diameter measurements to predict rapid growth has limited efficacy, as some smaller AAAs grow rapidly, whereas large AAAs may grow more slowly.…”