Comparing maximum diameter and volume when assessing the growth of small abdominal aortic aneurysms using longitudinal CTA data: cohort study.

Autor:	Ristl R; Center for Medical Statistics, Informatics, and Intelligent Systems., Klopf J; Department of General Surgery, Division of Vascular Surgery., Scheuba A; Department of General Surgery, Division of Vascular Surgery., Sotir A; Department of General Surgery, Division of Vascular Surgery., Wolf F; Department of Biomedical Imaging and Image Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Austria., Domenig CM; Department of General Surgery, Division of Vascular Surgery., Wanhainen A; Department of Surgical Sciences, Uppsala University, Uppsala.; Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden., Neumayer C; Department of General Surgery, Division of Vascular Surgery., Posch M; Center for Medical Statistics, Informatics, and Intelligent Systems., Brostjan C; Department of General Surgery, Division of Vascular Surgery., Eilenberg W; Department of General Surgery, Division of Vascular Surgery.
Jazyk:	angličtina
Zdroj:	International journal of surgery (London, England) [Int J Surg] 2023 Aug 01; Vol. 109 (8), pp. 2249-2257. Date of Electronic Publication: 2023 Aug 01.
DOI:	10.1097/JS9.0000000000000433
Abstrakt:	Background: Monitoring of abdominal aortic aneurysms (AAAs) is currently based on serial measurements of maximum aortic diameter. Additional assessment of aneurysm volume has previously been proposed to possibly improve growth prediction and treatment decisions. To evaluate the use of supplementing volume measurements, the authors aimed to characterise the growth distribution of AAA volume and to compare the growth rates of the maximum diameter and volume at the patient level. Methods: Maximum diameter and volume were monitored every 6 months in 84 patients with small AAAs, with a total of 331 computed tomographic angiographies (with initial maximum diameters of 30-68 mm). A previously developed statistical growth model for AAAs was applied to assess the growth distribution of volume and to compare individual growth rates for volume and for maximum diameter. Results: The median (25-75% quantile) expansion in volume was 13.4 (6.5-24.7) % per year. Cube root transformed volume and maximum diameter showed a closely linear association with a within-subject correlation of 0.77. At the surgery threshold maximum diameter of 55 mm, the median (25-75% quantile) volume was 132 (103-167) ml. In 39% of subjects, growth rates for volume and maximum diameter were equivalent, in 33% growth was faster in volume and in 27% growth was faster in maximum diameter. Conclusion: At the population level, volume and maximum diameter show a substantial association such that the average volume is approximately proportional to the average maximum diameter raised to a power of three. At the individual level, however, in the majority of patient's AAAs grow at different pace in different dimensions. Hence, closer monitoring of aneurysms with sub-critical diameter but suspicious morphology may benefit from complementing maximum diameter by volume or related measurements. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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