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- Gürtelschmid, Mikael, et al.
(författare)
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Comparison of three ultrasound methods of measuring the diameter of the abdominal aorta
- 2014
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 101:6, s. 633-636
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Tidskriftsartikel (refereegranskat)abstract
- Background: Three ultrasound methods of measuring the diameter of the abdominal aorta exist: the outer-to-outer (OTO) method, where callipers are placed on the outer layer of the aortic wall; the inner-to-inner (ITI) method, where callipers are placed on the inner layer of the aortic wall; and the leading edge-to-leading edge (LELE) method, where callipers are placed on the outer layer of the anterior wall and the inner layer of the posterior wall. The aim was to determine the variability of the three methods, differences between them, and the consequences on prevalence estimates. Methods: Some 127 consecutive patients with a small abdominal aortic aneurysm (AAA) were included. The maximal anteroposterior diameter was measured using the OTO, ITI and LELE methods by two vascular sonographers who were blinded to each other's measurements. The variability was described as the standard deviation. Results: The variability was 2.7 (95 per cent limits of agreements +/- 5.4) mmfor the OTO, 2.3 (+/- 4.6) mm for the ITI and 2.0 (+/- 4.0) mm for the LELE method. The corresponding coefficients of variability were 6.4, 6.1 and 5.0 per cent. The difference was 4.1mm between ITI and OTO (P < 0.001), 2.0 mm between ITI and LELE (P < 0.001), and 2.1mm between LELE and OTO (P < 0.001). Conclusion: LELE measurement was the most reproducible method of measuring the abdominal aorta. All methods showed a high degree of variability.
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| 2. |
- Svensjö, Sverker, et al.
(författare)
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Low prevalence of abdominal aortic aneurysm among 65-year-old Swedish men indicates a change in the epidemiology of the disease
- 2011
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Ingår i: Circulation. - 0009-7322 .- 1524-4539. ; 124:10, s. 1118-1123
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Screening elderly men with ultrasound is an established method to reduce mortality from ruptured abdominal aortic aneurysm (AAA; Evidence Level 1a). Such programs are being implemented and generally consist of a single scan at 65 years of age. We report the results from screening 65-year-old men for AAA in middle Sweden.METHODS AND RESULTS:All 65-year-old men (n=26,256), identified through the National Population Registry, were invited to an ultrasound examination. An AAA was defined as a maximum infrarenal aortic diameter of ≥30 mm. In total, 22 187 (85%) accepted, and 373 AAAs were detected (1.7%; 95% confidence interval, 1.5 to 1.9). With 127 previously known AAAs (repaired/under surveillance) included, the total prevalence of the disease in the population was 2.2% (95% confidence interval, 2.0 to 2.4). Self-reported smoking (odds ratio, 3.4; P<0.001), coronary artery disease (odds ratio, 2.0; P<0.001), and hypertension (odds ratio, 1.6; P=0.001) were independently associated with AAA in a multivariate logistic regression model. Thirteen percent of the entire population reported to be current smokers, one third of the frequency reported in the 1980s. The observed low prevalence of AAA was explained mainly by this change in smoking habits.CONCLUSIONS:On the basis of the observed reduced exposure to risk factors, lower-than-expected prevalence of AAA among 65-year-old men, unchanged AAA repair rate, and significantly improved longevity of the elderly population, the current generally agreed-on AAA screening model can be questioned. Important issues to address are the threshold diameter for follow-up, the possible need for rescreening at a higher age, and selective screening among smokers.
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