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[Growth rates of aortic aneurysms as a risk factor in rupture: an evaluation with CT]
Y Hirose1, S Hamada, M Takamiya
1Department of Radiology, National Cardiovascular Center, Osaka University Medical School.
Insights
This study determined aortic aneurysm growth rates. Thoracic aortic aneurysms grew faster than abdominal ones, with aortic arch aneurysms showing the highest growth, impacting survival rates.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Medical Imaging
Background:
- Aortic aneurysms are a significant health concern.
- Limited data exists on the growth rates of thoracic and abdominal aortic aneurysms.
- Understanding growth dynamics is crucial for patient management and prognosis.
Purpose of the Study:
- To determine the growth rates of thoracic and abdominal aortic aneurysms.
- To investigate the relationship between aneurysm growth rate and patient survival.
- To identify specific aneurysm locations with accelerated growth.
Main Methods:
- Prospective follow-up of 171 patients with nonoperatively managed aortic aneurysms.
- Sequential computed tomography (CT) scans used to measure aneurysm size over time.
- Analysis of 211 aneurysms (82 thoracic, 129 abdominal) with a minimum follow-up of 6 months.
Main Results:
- Average growth rates: 0.42 cm/year for thoracic aortic aneurysms and 0.28 cm/year for abdominal aortic aneurysms.
- Aortic arch aneurysms exhibited a significantly higher average growth rate (0.56 cm/year) compared to other thoracic levels (p < 0.05).
- A trend indicated that higher growth rates correlated with worse survival rates, particularly for aortic arch aneurysms exceeding the mean growth rate.
Conclusions:
- Thoracic aortic aneurysms, especially those in the aortic arch, demonstrate accelerated growth.
- Frequent CT monitoring of size is recommended for thoracic aortic aneurysms, particularly aortic arch aneurysms.
- Aneurysm growth rate is a potential indicator of prognosis and survival.
Abstract:
There is a lack of information on the rates of growth of aortic aneurysms. In the present study, the growth rates and survival rates of thoracic and abdominal aortic aneurysms were determined. One hundred seventy-one patients with aortic aneurysm managed nonoperatively have been followed more than 6 months with sequential X-ray computed tomography. The number of aneurysms was 211 (thoracic aortic aneurysm: 82, abdominal aortic aneurysm: 129). The growth rate of thoracic and abdominal aortic aneurysms were 0.42 and 0.28 cm/year, respectively. Aneurysms at the aortic arch (n = 34) grow at a higher average rate (0.56 cm/year) than aneurysms arising at other levels (p < 0.05). The survival rates showed the tendency that the higher the growth rate, the worse the survival rate. The survival rate of aortic arch aneurysm was significantly decreased when the growth rate was higher than the mean value. It is recommended that thoracic aortic aneurysms, especially aortic arch aneurysms, be followed frequently with computed tomographic examination of size.