Outcome of the Swedish Nationwide Abdominal Aortic Aneurysm Screening Program

Wanhainen, Anders; Hultgren, Rebecka; Linné, Anneli; Holst, Jan; Gottsäter, Anders; Langenskiöld, Marcus; Smidfelt, Kristian; Björck, Martin; Svensjö, Sverker

doi:10.1161/circulationaha.116.022305

Cited by 227 publications

(132 citation statements)

References 29 publications

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“…It is drummed into rural Australians that they are responsible for their health, so many may have had previous investigations where their AAA will have been diagnosed already. This seems different from the UK and Swedish populations, 5,6 where the background level of investigation appears lower and the rate of undetected disease higher. Screening programs have more to offer populations such as these.…”

contrasting

confidence: 62%

Final Say on Research Into Population Screening for Abdominal Aortic Aneurysm

Earnshaw

2017

Angiology

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contrasting

confidence: 62%

Final Say on Research Into Population Screening for Abdominal Aortic Aneurysm

Earnshaw

2017

Angiology

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“…Attendance (86 per cent) after invitation to screening for siblings was similar to that for men invited to the MASS (80 per cent), as well as the reported contemporary attendance in the Swedish AAA Screening Programme (84 per cent) and the National Health Service AAA Screening Programme (NAAASP) in England (78 per cent).…”

Section: Methodsmentioning

confidence: 52%

“…The estimated ARR of five prevented deaths from AAA per 1000 invited in this study is approximately three times higher than the estimated ARR of the Swedish AAA Screening Programme for 65‐year‐old men. This is a consequence of targeting a population with a much higher prevalence of AAA.…”

Section: Discussionmentioning

confidence: 63%

Cost-effectiveness of targeted screening for abdominal aortic aneurysm in siblings

Hultgren

Linné

Svensjö

2019

British Journal of Surgery

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Background Population screening for abdominal aortic aneurysm (AAA) in 65‐year‐old men has been shown to be cost‐effective. A risk group with higher prevalence is siblings of patients with an AAA. This health economic model‐based study evaluated the potential cost‐effectiveness of targeted AAA screening of siblings. Methods A Markov model validated against other screening programmes was used. Two methods of identifying siblings were analysed: direct questioning of patients with an AAA (method A), and employing a national multigeneration register (method B). The prevalence was based on observed ultrasound data on AAAs in siblings. Additional parameters were extracted from RCTs, vascular registers, literature and ongoing screening. The outcome was cost‐effectiveness, probability of cost‐effectiveness at different willingness‐to‐pay (WTP) thresholds, reduction in AAA death, quality‐adjusted life‐years (QALYs) gained and total costs on a national scale. Results Methods A and B were estimated to reduce mortality from AAA, at incremental cost‐effectiveness ratios of €7800 (95 per cent c.i. 4627 to 12 982) and €7666 (5000 to 13 373) per QALY respectively. The probability of cost‐effectiveness was 99 per cent at a WTP of €23 000. The absolute risk reduction in AAA deaths was five per 1000 invited. QALYs gained were 27 per 1000 invited. In a population of ten million, methods A and B were estimated to prevent 12 and 17 AAA deaths, among 2418 and 3572 siblings identified annually, at total costs of €499 500 and €728 700 respectively. Conclusion The analysis indicates that aneurysm‐related mortality could be decreased cost‐effectively by applying a targeted screening method for siblings of patients with an AAA.

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“…-There is a perfect correlation between the two techniques when assessing the diameter of the residual aneurysmal sac [10][11][12][13][14][15].…”

Section: Resultsmentioning

confidence: 99%

Demystifying Endovascular Treatment of Abdominal Aortic Aneurysms: A Study by CT Angiography at a Tertiary Hospital

Razak¹,

Gupta²,

Meena³

2017

Angiol

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Aims & Objectives: The aim of this study is to compare the results of Doppler ultrasound with enhancer (EDP) versus CT angiography in the follow-up of patients with AAA(Abdominal-aortic-aneurysms) treated with EVAR(endovascular treatment), compare our results with the published literature and be able to validate the EDP in our hospital for the follow-up of AAAs treated by EVAR. Material & Methods:Of all patients with AAA treated by EVAR in our P.B.M hospital and to whom controls are being performed, 22 patients were randomly selected. The informed consent of the patients was obtained both for the performance of the control CT angiography and for the realization of the EDP. All of them underwent first a CT angiography and then the EDP. Two radiologists, one with 21 years of experience in EDP and the other radiologist with 3 years of experience in angio-CT, independently analyzed the results of the tests without knowing the results of the other test. Results:The mean diameter of the residual aneurysmal sac measured by EDP was 64.49 ± 15.12 mm (41.5-104) with a median of 63 mm and measured by angio-CT showed an average diameter of 59.41 ± 17.54 mm (30-108) with a median of 59 mm. Angio-CT identified a leak in 13.63% of the cases (n=3). The EDP demonstrated leakage in 31.82% of the cases (n=7), all type II; in 85.72% of cases (n=6) they corresponded to hyperdynamic type II leaks (before 100 seconds) and 14.28% of cases (n=1) corresponded to hypodynamic type II leaks (after 100 seconds). The values of sensitivity, specificity, positive and negative predictive value of the EDP were: sensitivity 100%, specificity 79%, positive predictive value 43% and negative predictive value 100%. Conclusion:The EDP is a technique that does not irradiate, it can be used in patients in whom the use of iodinated contaste is contraindicated. It is more specific than angio-CT for detecting low-flow leaks, being able to consider it as the first modality of imaging in the follow-up of patients after EVAR. The EDP allows an economic saving since the angio-CT or angio-MR are more expensive than the realization of an EDP. Our results are in agreement with those published by other authors, but we need a wider series to give greater statistical strength to our results. There is a perfect correlation between the two techniques when assessing the diameter of the residual aneurysmal sac.

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Outcome of the Swedish Nationwide Abdominal Aortic Aneurysm Screening Program

Cited by 227 publications

References 29 publications

Final Say on Research Into Population Screening for Abdominal Aortic Aneurysm

Final Say on Research Into Population Screening for Abdominal Aortic Aneurysm

Cost-effectiveness of targeted screening for abdominal aortic aneurysm in siblings

Demystifying Endovascular Treatment of Abdominal Aortic Aneurysms: A Study by CT Angiography at a Tertiary Hospital

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