Impact of gender and body surface area on outcome after abdominal aortic aneurysm repair

Matyal, Robina; Shakil, Omair; Hess, Philip E.; Lo, Ruby C.; Jainandunsing, Jayant S.; Mahmood, Bilal; Hartman, Greg S.; Schermerhorn, Marc L.; Mahmood, Feroze

doi:10.1016/j.amjsurg.2014.07.008

Cited by 23 publications

(13 citation statements)

References 27 publications

(28 reference statements)

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“…Additionally, data suggest that measurement of aneurysm size should take into account body surface area; at the time of intervention, women often have larger aneurysms relative to body surface area, which may put them at a greater risk of rupture. 114,115 Other studies suggest differences in biochemical properties between men and women may account for disparate outcomes. 116…”

Section: Abdominal Aortic Aneurysm Interventionmentioning

confidence: 99%

Sex-related differences in outcomes after vascular interventions

Brinza

Armstrong

2018

Vasc Med

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Section: Abdominal Aortic Aneurysm Interventionmentioning

confidence: 99%

Sex-related differences in outcomes after vascular interventions

Brinza

Armstrong

2018

Vasc Med

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“…28 –30 An adjunct to just measuring AD could be to use the ASI. 15,17,31 Our data suggest that AAA patients with ASI <1.5 could be followed-up at less frequent intervals (3-4 years), but an ASI >2.0 could be followed-up using the present intervals. To use ASI in surveillance programs instead of only AD cannot be generally recommended at this time but should be investigated further.…”

Section: Discussionmentioning

confidence: 71%

“…14,15 Alternative methods to surveille AAA diameter, by correlating the aortic maximum diameter to the body surface area (BSA), that is, the Aortic Size Index (ASI), have been proposed as adjuncts in precision care. 15 –17…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up of Men Invited to Participate in a Population-Based Abdominal Aortic Aneurysm Screening Program

et al. 2020

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A screening program for abdominal aortic aneurysm (AAA), inviting 65-year-old men, was started in Stockholm in 2010 (2.3 million inhabitants). The aim was to present a long-term follow-up of men participating in screening, as well as AAA repair and ruptures among nonparticipants. Demographics were collected for men with screening detected with AAA 2010 to 2016 (n = 672) and a control group with normal aortas at screening (controls, n = 237). Medical charts and regional Swedvasc (Swedish Vascular registry) data were analyzed for aortic repair for men born 1945 to 1951. Ultrasound maximum aortic diameter (AD) as well as Aortic Size Index (ASI) was recorded. Participation was 78% and prevalence of AAA was 1.2% (n = 672). Aortic repair rates correlated with high ASI and AD. During the study period, 22% of the AAA patients were treated with the elective repair; 35 men in surveillance died (5.2%), non-AAA-related causes (82.9%) dominated, followed by unknown causes among 4 (11.4%), and 2 (5.7%) possibly AAA-related deaths. Abdominal aortic aneurysm rupture rate was higher among nonparticipants (0.096% vs 0.0036%, P < .001). The low dropout rate confirms acceptability of follow-up after screening. The efficacy is shown by the much higher rupture rate among the nonparticipating men.

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“…6 Indeed, we and others noted that women have larger aneurysms at the time of repair than men if ASI, rather than diameter, as used as a marker of size. 6,45 Additionally, we found that after adjusting for demographics, comorbidities, and aortic diameter, female patients had higher perioperative mortality after intact open and endovascular AAA repair; however, adjusting for ASI rather than diameter mitigated much of this disparity. 8 We feel that ASI may be a more suitable marker for rupture risk than diameter in female patients and, therefore, may be more appropriately used to identify thresholds for repair.…”

Section: Introductionmentioning

confidence: 78%

Should Abdominal Aortic Aneurysms in Women be Repaired at a Lower Diameter Threshold?

Deery

Schermerhorn

2018

Vasc Endovascular Surg

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Abdominal aortic aneurysm (AAA) primarily affects male patients; however, female patients with AAA have a faster rate of aneurysm growth, have higher risk of rupture even at smaller diameters, and have worse outcomes following repair of ruptured and intact aneurysms. Furthermore, early natural history studies and randomized controlled trials evaluating surveillance versus repair in small aneurysms were conducted primarily in male patients. Therefore, there are limited data regarding the ideal threshold for elective repair of AAA in women, either by aortic diameter or by alternative measures. We review the existing literature regarding AAA in women and consider the most appropriate threshold for repair.

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Impact of gender and body surface area on outcome after abdominal aortic aneurysm repair

Cited by 23 publications

References 27 publications

Sex-related differences in outcomes after vascular interventions

Sex-related differences in outcomes after vascular interventions

Long-Term Follow-Up of Men Invited to Participate in a Population-Based Abdominal Aortic Aneurysm Screening Program

Should Abdominal Aortic Aneurysms in Women be Repaired at a Lower Diameter Threshold?

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