Prevalence of Abdominal Aortic Aneurysms in the United States: Re-evaluating the Screening Guidelines

Abstract

A single-center analysis of pediatric patients with acute IFAT from 2011 to 2019 was conducted. Medical records and vascular laboratory studies were reviewed retrospectively. Patients with one or more surveillance US studies were included. Thrombus resolution was defined as multiphasic flow throughout the index limb without evidence of echogenic intraluminal material by US. Time to resolution of thrombus was assessed using Kaplan-Meier analysis. Results: Fifty-four limbs in 50 patients were identified. The median age was 2.2 months (interquartile range, 0.7-4.8 months), with a median weight of 4.2 kg (interquartile range, 3.3-5.5 kg). The majority of patients (65%) presented with a diminished pedal Doppler signal, commonly after cardiac catheterization (56%). Forty-eight (89%) limbs had complete arterial occlusion on index US, and flow could not be detected below the ankle in 58%. The median number of US examinations per limb was three (range, two-seven), and 39% of limbs had a surveillance US study within 7 days of diagnosis. In patients treated with anticoagulation, estimated resolution of thrombus was 46% at 14 days and 75% at 30 days (Fig 1). Eight (15%) patients did not receive anticoagulation, and only one of these patients experienced thrombus resolution. At the time of diagnosis, one patient underwent surgical revascularization because of a contraindication to anticoagulation, and one patient was treated with thrombolysis. There were no instances of tissue loss or amputation. Conclusions: Management of IFAT with anticoagulation alone resulted in successful short-term outcomes. Based on the observed rate of resolution, management should start with anticoagulation, followed by surveillance US at 2-week intervals (Fig 2). With treatment by anticoagulation, resolution can be expected to occur in 50% of patients every 2 weeks, with few resolving beyond 4 weeks.

An Epidemiologic Study of the Incidence and Mortality of Abdominal Aortic Aneurysms in Koreans Aged ≥50 Years from 2009 to 2018 Based on a National Database

“…Previous studies regarding the epidemiology of AAA in Western countries vary in the definition of AAA and/or the study population. The prevalence of AAA in these studies ranged from 1.3% to 8% [ 11 , 12 , 13 , 14 , 15 , 16 ], and the annual incidence of newly diagnosed AAA in screened populations ranged from 0.4% to 0.67% [ 17 , 18 ]. Although most Asian countries have not yet adopted a screening program for AAA, making it difficult to determine its exact prevalence, the incidence of AAA is generally thought to be lower in Asian than in Western populations [ 19 ].…”

Prevalence and epidemiological pattern of abdominal aortic aneurysms in Africa: A systematic review

“…The prevalence reported in these studies is comparable to, if not higher than what has been reported in some Western countries. [ 46 47 ]…”