Selective management of abdominal aortic aneurysms smaller than 5.0 cm in a prospective sizing program with gender-specific analysis

Abstract

The study confirms the results of the United Kingdom Small Aneurysm Trial and the Aneurysm Detection and Management Study, that is, that risk for rupture is extremely unlikely with AAA smaller than 5.0 cm, which enables safe follow-up surveillance programs in both men and women with AAA smaller than 5.0 cm.

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

“…The publication dates of the 15 potentially eligible studies 13,22,[29][30][31][32][33][34][35][36][37][38][39][40][41] ranged from 1994 to 2009, with patient recruitment from 1976 to 2005. Of these, 10 were prospective studies 13,22,[34][35][36][37][38][39][40][41] (including three randomised trials), four included both retrospective and prospective data 29,30,32,33 and one study reported only retrospective data.…”

“…Of these, 10 were prospective studies 13,22,[34][35][36][37][38][39][40][41] (including three randomised trials), four included both retrospective and prospective data 29,30,32,33 and one study reported only retrospective data. 31 Aneurysm growth was the primary outcome measure in 10 of the 15 studies.…”

“…The mean baseline age ranged from 65 to 71 years, although age was not reported in two studies. 29,30 The study size ranged from 134 to 1743 patients, with most patients followed up for between 1 and 5 years; not all of these studies stated the mean length of follow-up or patient-years of follow-up.…”

“…Some studies used CT as well as US. 22,29,33 Most of these studies included aortic diameters from 30 mm (at baseline), except three studies, which reported from either 25 mm 31,35 or 28 mm. 13 Not all studies restricted their reporting to the aneurysm diameter range of interest (3.0-5.5 cm) and in some instances substudies were identified, which reported on a more restricted range.…”

“…13 Not all studies restricted their reporting to the aneurysm diameter range of interest (3.0-5.5 cm) and in some instances substudies were identified, which reported on a more restricted range. 13,29,33 Different methods were used to estimate aneurysm growth, usually reported as mm/year, with linear regression or (last-first diameter)/time being the most common; two studies did not report how they estimated aneurysm growth. 29,36 One study only reported percentage changes in aneurysm diameter and used data from two screening programmes (Chichester and Huntingdon).…”