Imaging Predictive Factors of Abdominal Aortic Aneurysm Growth.

Petroula Nana,Konstantinos Dakis,Konstantinos Spanos,George Kouvelos,Alexandros Brodis

doi:10.3390/jcm10091917

Petroula Nana, Konstantinos Dakis + Show 3 more

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https://doi.org/10.3390/jcm10091917

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Abstract

Background: Variable imaging methods may add important information about abdominal aortic aneurysm (AAA) progression. The aim of this study is to assess available literature data regarding the predictive imaging factors of AAA growth. Methods: This systematic review was conducted using the PRISMA guidelines. A review of the literature was conducted, using PubMed, EMBASE and CENTRAL databases. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Primary outcomes were defined as AAA growth rate and factors associated to sac expansion. Results: The analysis included 23 studies. All patients (2244; mean age; 69.8 years, males; 85%) underwent imaging with different modalities; the initial evaluation was followed by one or more studies to assess aortic expansion. AAA initial diameter was reported in 13 studies (range 19.9–50.9 mm). Mean follow-up was 34.5 months. AAA diameter at the end was ranging between 20.3 and 55 mm. The initial diameter and intraluminal thrombus were characterized as prognostic factors associated to aneurysm expansion. A negative association between atherosclerosis and AAA expansion was documented. Conclusions: Aneurysm diameter is the most studied factor to be associated with expansion and the main indication for intervention. Appropriate diagnostic modalities may account for different anatomical characteristics and identify aneurysms with rapid growth and higher rupture risk. Future perspectives, including computed mathematical models that will assess wall stress and elasticity and further flow characteristics, may offer valuable alternatives in AAA growth prediction.

Highlights

Published: 28 April 2021Abdominal aortic aneurysm (AAA) is a progressive disease, associated with an increase of the sac diameter during time [1,2]
Many clinical trials have focused on different medical factors, which could affect the limitation of growth of small abdominal aortic aneurysm (AAA) by targeting some of the pathways that seem to be associated with AAA formation and growth [4,5,6,7,8,9,10]
The main criterion was that all the included studies reporting on imaging findings, irrespectively of the method, associated with AAA growth in patients without previous open or endovascular repair

Summary

Introduction

Abdominal aortic aneurysm (AAA) is a progressive disease, associated with an increase of the sac diameter during time [1,2]. AAA diameter remains the most applied and significant marker of growth [2]. Individualized factors, such as smoking or diabetes, have been proved to alternate AAA evolution positively or negatively, while sex does not seem to affect AAA growth rate [3]. Many clinical trials have focused on different medical factors, which could affect the limitation of growth of small AAA by targeting some of the pathways that seem to be associated with AAA formation and growth [4,5,6,7,8,9,10]. Standardized reproducible imaging methods and newer imaging assessments are mandatory and may add important information about

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