Recommendations for screening intervals for small aortic aneurysms

McCarthy, Robert J.; Shaw, E.; Whyman, M. R.; Earnshaw, J. J.; Poskitt, K. R.; Heather, B. P.

doi:10.1002/bjs.4216

Cited by 76 publications

(71 citation statements)

References 19 publications

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“…The publication dates of the 15 potentially eligible studies 13,22,[29][30][31][32][33][34][35][36][37][38][39][40][41] ranged from 1994 to 2009, with patient recruitment from 1976 to 2005. Of these, 10 were prospective studies 13,22,[34][35][36][37][38][39][40][41] (including three randomised trials), four included both retrospective and prospective data 29,30,32,33 and one study reported only retrospective data.…”

Section: Study Characteristicsmentioning

confidence: 99%

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Thompson

Brown²,

Sweeting³

et al. 2013

Health Technology Assessment

186

177

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This report should be referenced as follows:Thompson SG, Brown LC, Sweeting MJ, Bown MJ, Kim LG, Glover MJ, et al. Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness. Health Technol Assess 2013;17(41). Health Technology Assessment is indexed in MEDLINE, CINAHL, EMBASE, The Cochrane Library and the ISI Science Citation Index and is assessed for inclusion in the Database of Abstracts of Reviews of Effects. Health Technology Assessment is indexed and abstracted inThis journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/30/02. The contractual start date was in November 2009. The draft report began editorial review in July 2012 and was accepted for publication in November 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research...

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Section: Study Characteristicsmentioning

confidence: 99%

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Thompson

Brown²,

Sweeting³

et al. 2013

Health Technology Assessment

186

177

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“…A sample schedule of surveillance imaging is summarized in the Table. [53][54][55][56] In a recent analysis of aneurysm growth, Brady et al 53 have estimated that following such a rescreening algorithm would limit the possibility of an aneurysm reaching Ͼ5.5 cm between screenings to Ͻ1%. When monitoring growth of aneurysms with a diameter Ն4 cm, CT scanning may be preferable to ultrasound because CT sizing is more accurate.…”

Section: Medical Managementmentioning

confidence: 99%

Thoracic and Abdominal Aortic Aneurysms

2005

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“…Although surveillance at 6-month intervals for those with AAA Ն46 mm in diameter has proved safe in practice, 4 when the diameter exceeds 50 mm, surveillance at 3-month intervals would have a higher safety margin (Figure 2). The different studies 6,7,9,25 evaluating time to reach a threshold diameter have used different populations, thresholds, and methodologies, providing variable results: Pooling data in a metaanalysis could resolve these differences and improve the evidence base for screening interval guidelines.…”

Section: Brady Et Al Abdominal Aortic Aneurysm Expansionmentioning

confidence: 99%

“…6 Recently, screening intervals for those with AAA Ͻ40 mm in diameter have been derived from a UK screening program. 7 A screening interval of 1 year for those with AAA 35 to 39 mm in diameter was recommended because, during this interval, only 2 of 166 patients had aneurysms of 55 mm or greater and no patient had required surgery or suffered AAA rupture. 7 Others have suggested a 2-or 3-year screening interval for AAA Ͻ40 mm.…”

mentioning

confidence: 99%

“…7 A screening interval of 1 year for those with AAA 35 to 39 mm in diameter was recommended because, during this interval, only 2 of 166 patients had aneurysms of 55 mm or greater and no patient had required surgery or suffered AAA rupture. 7 Others have suggested a 2-or 3-year screening interval for AAA Ͻ40 mm. 8,9 Studies of AAA expansion, and the factors associated with expansion, have been limited by small sample sizes and mostly analyzed by linear regression.…”

mentioning

confidence: 99%

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Abdominal aortic aneurysm expansion: Risk factors and time intervals for surveillance

Brady¹,

Thompson²,

Fowkes³

et al. 2004

ACC Current Journal Review

210

360

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on behalf of the UK Small Aneurysm Trial Participants Background-Intervention to reduce abdominal aortic aneurysm (AAA) expansion and optimization of screening intervals would improve current surveillance programs. The aim of this study was to characterize AAA growth in a national cohort of patients with AAA both overall and by cardiovascular risk factors. Methods and Results-In this study, 1743 patients were monitored for changes in AAA diameter by ultrasonography over a mean follow-up of 1.9 years. Mean initial AAA diameter and growth rate were 43 mm (range 28 to 85 mm) and 2.6 mm/year (95% range, Ϫ1.0 to 6.1 mm/year), respectively. Baseline diameter was strongly associated with growth, suggesting that AAA growth accelerates as the aneurysm enlarges. AAA growth rate was lower in those with low ankle/brachial pressure index and diabetes but higher for current smokers (all PϽ0.001). No other factor (including lipids and blood pressure) was associated with AAA growth. Intervals of 36, 24, 12, and 3 months for aneurysms of 35, 40, 45, and 50 mm, respectively, would restrict the probability of breaching the 55-mm limit at rescreening to below 1%. Conclusions

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Recommendations for screening intervals for small aortic aneurysms

Abstract: The appropriate rescreening interval can be determined by initial aortic diameter in screened 65-year-old men. AAAs of initial diameter 2.6-2.9 cm should be rescanned at 5 years, those of 3.0-3.4 cm at 3 years and those of 3.5-3.9 cm at 1 year.

Cited by 76 publications

References 19 publications

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Thoracic and Abdominal Aortic Aneurysms

Abdominal aortic aneurysm expansion: Risk factors and time intervals for surveillance

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