Morphologic Features of Symptomatic and Ruptured Abdominal Aortic Aneurysm in Asian Patients

Wang, Huaxin; Ou, Jing; Gong, Wei; Wang, Haibo; Freebody, John

doi:10.1016/j.avsg.2020.09.059

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…However, this may be due to the smaller aortic diameter in the Asian populations, 17 and also due to the predisposition to symptomatic/ruptured presentation at smaller diameters in the Asian population. 18 The present study suggests that if AAAs are classified by size, each size range has its own unique characteristics: small AAAs might rupture regardless of sac morphology or sex, although this is very rare, while the rupture risk of medium AAAs can be greatly affected by saccular morphology rather than sac diameter, and the rupture risk of large AAAs can be affected by sac diameter rather than sac morphology. Regarding small AAAs, surveillance at intervals of several years is clinically acceptable for men with AAAs in the range of 30 to 40 mm.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 69%

Comparison of Rupture Risk Between Saccular and Fusiform Abdominal Aortic Aneurysms Using a National Clinical Database in Japan

Ozawa

Takahashi

Bessho

et al. 2023

Preprint

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Background: Saccular AAAs are thought to pose an elevated risk of rupture, but not much is known about the extent of this risk. Therefore, we aimed to conduct a survey of saccular abdominal aortic aneurysms (AAAs) and to compare the risk of rupture between fusiform and saccular AAAs. Methods: We performed a retrospective cohort study on patients who underwent primary endovascular repair for a degenerative AAA between 2016 and 2019, and who were registered in the National Clinical Database in Japan. Results: A total of 27,290 patients were included in the study. Of these, 7.8 % (n=2142) had saccular AAAs and the remaining 92.2% (n = 25,148) were fusiform. In addition, 4.3% (n = 92) of saccular AAAs and 5.4% (n = 1351) of fusiform AAAs were ruptured. Saccular AAAs ruptured at smaller dimeters than fusiform AAAs (median, 55.6 mm vs 68.0 mm, p < 0.001), and were operated on at smaller diameters than fusiform AAAs in non-ruptured cases (median, 44.0 mm vs 51.0 mm, p < 0.001). The rupture rate was significantly higher in saccular AAAs than in fusiform AAAs in the 40-54 mm diameter range, in which saccular morphology was found to be an independent risk factor for rupture by adjusting for gender and aneurysm diameter (odds ratio, 2.54, 95% confidence interval, 1.75-3.69). In addition, receiver-operating characteristic analysis revealed that the cut-off diameter to predict rupture was smaller in saccular AAAs than in fusiform AAAs (50.5 mm and 59.5 mm, respectively). Conclusion: Saccular AAAs are more prone to rupture than fusiform AAAs in the 40-54 mm diameter range, which supports the idea that saccular AAAs should be treated at smaller diameters. The 9.0 mm difference in the predicted diameters for the rupture between fusiform and saccular AAAs suggests that the threshold diameter for intervention of saccular AAAs can be set approximately 1 cm smaller than that of fusiform AAAs.

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Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 69%

Comparison of Rupture Risk Between Saccular and Fusiform Abdominal Aortic Aneurysms Using a National Clinical Database in Japan

Ozawa

Takahashi

Bessho

et al. 2023

Preprint

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“…However, this may be attributable to the smaller aortic diameter in the Asian populations, 19 and attributable to the predisposition to symptomatic/ruptured presentation at smaller diameters in the Asian population. 20 …”

Section: Discussionmentioning

confidence: 99%

Saccular and Fusiform Abdominal Aortic Aneurysms Treated With Endovascular Repair Differ in Presentation and Treatment Threshold: Analyses Using a National Clinical Database in Japan

Ozawa,

Takahashi,

Bessho

et al. 2024

JAHA

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Background Saccular abdominal aortic aneurysms (AAAs) are considered to be at higher risk of rupture than fusiform AAAs, but not much is known about the extent of this risk. Therefore, this study aimed to compare the rupture presentation between fusiform and saccular AAAs. Methods and Results This is a retrospective cohort study on 27 290 patients who underwent primary endovascular repair for a degenerative AAA between 2016 and 2019, and who were registered in the National Clinical Database in Japan. At operation for nonruptured case, the aneurysm diameter was significantly smaller in saccular AAAs than in fusiform AAAs (median, 44.0 versus 51.0 mm; P <0.001). Similarly, aneurysm diameter at rupture was significantly smaller in saccular AAAs than in fusiform AAAs (median, 55.6 versus 68.0 mm; P <0.001). The likelihood of repair for rupture was significantly higher in saccular AAAs than in fusiform AAAs in the 40‐ to 54‐mm diameter range, in which saccular morphology was found to be an independent risk factor for rupture against fusiform morphology by adjusting for sex and aneurysm diameter (odds ratio, 2.54 [95% CI, 1.75–3.69]). In addition, receiver‐operating characteristic curve analysis revealed that the cutoff diameter to predict rupture was smaller in saccular AAAs than in fusiform AAAs (50.5 and 59.5 mm, respectively) based on the Youden index. Conclusions Saccular AAAs presented at smaller diameters than fusiform AAAs in patients with ruptured AAAs treated with endovascular aortic repair, which supports the idea that saccular AAAs should be treated at smaller diameters.

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CTA-Based Radiomics and Area Change Rate Predict Infrarenal Abdominal Aortic Aneurysms Patients Events: A Multicenter Study

Wang,

Liu,

et al. 2024

Academic Radiology

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Morphologic Features of Symptomatic and Ruptured Abdominal Aortic Aneurysm in Asian Patients

Cited by 5 publications

References 24 publications

Comparison of Rupture Risk Between Saccular and Fusiform Abdominal Aortic Aneurysms Using a National Clinical Database in Japan

Comparison of Rupture Risk Between Saccular and Fusiform Abdominal Aortic Aneurysms Using a National Clinical Database in Japan

Saccular and Fusiform Abdominal Aortic Aneurysms Treated With Endovascular Repair Differ in Presentation and Treatment Threshold: Analyses Using a National Clinical Database in Japan

CTA-Based Radiomics and Area Change Rate Predict Infrarenal Abdominal Aortic Aneurysms Patients Events: A Multicenter Study

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