Advanced

On the complexity of screening detected abdominal aortic aneurysms : A retrospective observational multicenter cohort study

Ohlsson, Håkan LU ; Gottsäter, Anders LU ; Resch, Tim LU ; Sonesson, Björn LU ; Malina, Martin LU ; Kjellin, Per; Wetterling, Tomas and Holst, Jan LU (2017) In International Angiology 36(3). p.261-267
Abstract

BACKGROUND: Ultrasound screening for abdominal aortic aneurysms (AAA) has been shown to decrease aneurysm related mortality. Likely by providing an opportunity to intervene while the aneurysm is still intact, but possibly also when and the anatomy still relatively uncomplicated which would provide a less complex procedure. Our aim was to retrospectively investigate the complexity of repair for screening-detected AAAs in a cohort of 65-year-old men. METHODS: All screening detected AAA cases that underwent repair between Sept 2010 and June 2014 in the most southern region of Sweden were included. Procedures were classified as either standard or complex. A standard procedure was defined as either standard EVAR (endovascular aneurysm... (More)

BACKGROUND: Ultrasound screening for abdominal aortic aneurysms (AAA) has been shown to decrease aneurysm related mortality. Likely by providing an opportunity to intervene while the aneurysm is still intact, but possibly also when and the anatomy still relatively uncomplicated which would provide a less complex procedure. Our aim was to retrospectively investigate the complexity of repair for screening-detected AAAs in a cohort of 65-year-old men. METHODS: All screening detected AAA cases that underwent repair between Sept 2010 and June 2014 in the most southern region of Sweden were included. Procedures were classified as either standard or complex. A standard procedure was defined as either standard EVAR (endovascular aneurysm repair) within the manufacturers Instructions For Use (IFU) or open repair with infrarenal clamping followed by a tube graft repair. All other types of procedures were defined as complex. The prevalence rate of AAA, screening compliance, short-and midterm outcome of the operations were reported. RESULTS: From the 35513 men invited to screening, 27 951 (78.7%) attended screening with ultrasound. AAA30 mm was found in 561 cases, yielding a prevalence rate of 2.0%. Forty-eight patients underwent AAA repair. A percentage of 43.8% of these were classified as complex procedures. These consisted mostly of branched/fenestrated EVAR or EVAR with simultaneous exclusion of common iliac aneurysm. CONCLUSIONS: Our study confirms contemporary prevalence rates of AAA. Almost half (43.8%) of screening-detected AAA required complex operations, a significant proportion. The complex aneurysms were, on average, larger than the non-complex cases and they were more likely to be cases that required surgery immediately after screening detection. Our data suggests that the nature of AAA is heterogenous, even in the screening-detected group requiring operation. This should spur interest in more studies to investigate this issue.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Abdominal, Aortic aneurysm, Endovascular procedures, Men
in
International Angiology
volume
36
issue
3
pages
7 pages
publisher
Minerva Medica
external identifiers
  • scopus:85017118607
ISSN
0392-9590
DOI
10.23736/S0392-9590.16.03740-8
language
English
LU publication?
yes
id
ffa21db8-c01d-49f9-bbbd-c288f420258c
date added to LUP
2017-05-04 15:59:13
date last changed
2017-05-05 03:00:03
@article{ffa21db8-c01d-49f9-bbbd-c288f420258c,
  abstract     = {<p>BACKGROUND: Ultrasound screening for abdominal aortic aneurysms (AAA) has been shown to decrease aneurysm related mortality. Likely by providing an opportunity to intervene while the aneurysm is still intact, but possibly also when and the anatomy still relatively uncomplicated which would provide a less complex procedure. Our aim was to retrospectively investigate the complexity of repair for screening-detected AAAs in a cohort of 65-year-old men. METHODS: All screening detected AAA cases that underwent repair between Sept 2010 and June 2014 in the most southern region of Sweden were included. Procedures were classified as either standard or complex. A standard procedure was defined as either standard EVAR (endovascular aneurysm repair) within the manufacturers Instructions For Use (IFU) or open repair with infrarenal clamping followed by a tube graft repair. All other types of procedures were defined as complex. The prevalence rate of AAA, screening compliance, short-and midterm outcome of the operations were reported. RESULTS: From the 35513 men invited to screening, 27 951 (78.7%) attended screening with ultrasound. AAA30 mm was found in 561 cases, yielding a prevalence rate of 2.0%. Forty-eight patients underwent AAA repair. A percentage of 43.8% of these were classified as complex procedures. These consisted mostly of branched/fenestrated EVAR or EVAR with simultaneous exclusion of common iliac aneurysm. CONCLUSIONS: Our study confirms contemporary prevalence rates of AAA. Almost half (43.8%) of screening-detected AAA required complex operations, a significant proportion. The complex aneurysms were, on average, larger than the non-complex cases and they were more likely to be cases that required surgery immediately after screening detection. Our data suggests that the nature of AAA is heterogenous, even in the screening-detected group requiring operation. This should spur interest in more studies to investigate this issue.</p>},
  author       = {Ohlsson, Håkan and Gottsäter, Anders and Resch, Tim and Sonesson, Björn and Malina, Martin and Kjellin, Per and Wetterling, Tomas and Holst, Jan},
  issn         = {0392-9590},
  keyword      = {Abdominal,Aortic aneurysm,Endovascular procedures,Men},
  language     = {eng},
  month        = {06},
  number       = {3},
  pages        = {261--267},
  publisher    = {Minerva Medica},
  series       = {International Angiology},
  title        = {On the complexity of screening detected abdominal aortic aneurysms : A retrospective observational multicenter cohort study},
  url          = {http://dx.doi.org/10.23736/S0392-9590.16.03740-8},
  volume       = {36},
  year         = {2017},
}