Expansion Rates of Small Abdominal Aortic Aneurysms

Abstract

Background:The present study was carried out in order to examine those factors that influence the rate of expansion of small abdominal aortic aneurysms. Methods: A retrospective study was undertaken of 112 patients who attended the St George Vascular Laboratory between 1987 and 1997. These patients had abdominal aortic aneurysms that were considered to be too small to warrant surgical repair at the time of presentation. Sequential ultrasound examinations were used to measure maximal anteroposterior aneurysm diameter. From these data, annual growth rates were calculated. Growth rate per annum was then compared with gender, age, initial aortic aneurysm diameter, presence of hypertensive disease, cardiac disease, family history of aneurysmal disease, diabetes mellitus, smoking, beta-adrenergic blockade and lipid lowering drugs. Results: Univariate analysis showed that three factors were significantly related to growth rate: the initial size of the aortic aneurysm, the presence of cardiac disease and the presence of beta-adrenergic blockade. Conclusions:The presence of beta-adrenergic blockade appeared to have an independent effect on aneurysm growth rate, and suggests a possible role for beta-adrenergic blockade as a therapeutic strategy in controlling expansion rates of small abdominal aortic aneurysms. A controlled double-blind clinical trial is required to demonstrate this conclusively.

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

“…Growth rates have been most widely documented for aortic aneurysms, several examples of which are presented in Table 46. These data confirm similar observations (931,932) (963). The annual rupture rate was negligible (0.6%) for observed aneurysms in the VA trial and was 3.2% in the UK trial.…”

ACC/AHA 2005 Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): Executive Summary A Collaborative Report From the American Association for Vascular Surgery/Society for Vascular Surgery,⁎⁎AAVS/SVS when Guideline initiated, now merged into SVSSociety for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guideline

“…These features contribute to the 3 most common complications of aneurysms, that is, rupture, thromboembolic ischemic events, and the compression or erosion of adjacent structures, which often are quite specific to their location. Aneurysm size remains the single most important predictor not only for aneurysm rupture but also for unrelated death from other cardiopulmonary events (280,281). Data suggest that the eventual risk for rupture is approximately 20% for aneurysms larger than 5.0 cm in diameter, 40% for those at least 6.0 cm in diameter, and greater than 50% for aneurysms that exceed 7.0 cm in diameter (Table 25).…”

Calculating when elective abdominal aortic aneurysm repair improves survival for individual patients: development of the Aneurysm Repair Decision Aid and economic evaluation

“…11 AAA growth rates increase as the AAA gets larger. [12][13][14] Growth rates have also been shown to be higher in smokers [15][16][17][18] and lower in patients taking beta blockers, 19 angiotensin-converting enzyme inhibitors or statins 20,21 and lower in patients with diabetes. 16,18,22,23 Most AAAs continue to grow until the aneurysm ruptures or is repaired or the patient dies of other causes.…”