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Risk of developing an abdominal aortic aneurysm after ectatic aorta detection from initial screening
Kevin C Chun1, Richard C Anderson1, Hunter C Smothers1
1Department of Research, Sacramento VA Medical Center, Mather, Calif.
Journal of Vascular Surgery
|November 12, 2019
Summary
Ectatic aortas (2.5-2.9 cm) in men screened for abdominal aortic aneurysm (AAA) can develop into AAA. Active smokers and those with COPD are at higher risk for AAA development.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Diagnostic Imaging
Background:
- Current abdominal aortic aneurysm (AAA) surveillance guidelines lack follow-up for screened patients with aortic diameters less than 3.0 cm.
- Some patients with ectatic aortas (2.5-2.9 cm) may develop late AAA formation and rupture.
Purpose of the Study:
- To determine the prevalence of ectatic aortas in AAA screening programs.
- To investigate AAA development, rupture risk, and associated risk factors in patients with ectatic aortas.
Main Methods:
- Retrospective chart review of AAA screening data from 2007-2016.
- Analysis of patients with ectatic aortas (2.5-2.9 cm) and subsequent follow-up imaging.
- Logistic regression and Cox proportional hazard models to identify AAA development risks and survival data.
Main Results:
- 16.3% of screened men (n=3205) had ectatic aortas.
- 28.7% of those with follow-up imaging developed AAA (mean 4.2 years).
- Larger initial diameter, COPD, and active smoking were associated with AAA development.
Conclusions:
- Patients with ectatic aortas who are active smokers or have COPD are likely to develop AAA.
- This highlights the need for potential follow-up recommendations for ectatic aortas in AAA screening.
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