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Volumetric Abdominal Aortic Aneurysm Analysis in Post EVAR Surveillance Settings
Kathryn Simmons1, David Weiss2, Mariam Aboian3
1Department of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT.
Annals of Vascular Surgery
|March 6, 2025
Summary
Aneurysm volume measurement is more sensitive than diameter for detecting abdominal aortic aneurysm (AAA) enlargement. This finding may improve AAA surveillance and reduce mortality through earlier detection of high-risk cases.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Quantitative Analysis
Background:
- Abdominal aortic aneurysm (AAA) early detection is crucial for diagnosis and management.
- Endovascular aneurysm repair (EVAR) is the primary treatment modality.
- Maximum diameter is standard for risk assessment, but volumetric analysis may offer greater sensitivity to size changes.
Purpose of the Study:
- To compare the utility of volumetric analysis versus maximum diameter measurement for assessing AAA size changes.
- To investigate clinical factors associated with AAA size changes detected by volume and diameter.
Main Methods:
- Retrospective review of patients undergoing EVAR with pre- and postoperative CT angiograms.
- Measurement of total aneurysm and lumen volume using semiautomatic segmentation.
- Extraction of maximum diameter and clinical variables; comparison of percent change in volume and diameter.
Main Results:
- Volumetric analysis was more sensitive in detecting aneurysm sac enlargement compared to diameter measurement (P=0.0315).
- A moderate positive correlation (rs=0.6662) was observed between percent change in volume and diameter.
- Increased volume and diameter were associated with older age and endoleak; decreased diameter was linked to metformin use.
Conclusions:
- Aneurysm volume measurement is more effective than diameter for detecting AAA enlargement.
- Enhanced detection of high-risk aneurysms through volumetric analysis may lead to improved surveillance strategies and reduced aneurysm-related mortality.
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