Growth Rate and Associated Factors in Small Abdominal Aortic Aneurysms

European Journal of Vascular and Endovascular Surgery(2006)

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摘要
Objective. To study the growth rate and factors influencing progression of small infrarenal abdominal aortic aneurysms (AAA). Design. Observatiotial, longitudinal, prospective study. Patients and methods. We followed patients With AAA < 5 cm in diameter in two groups. Group I (AAA 3-3.9 cm, n=246) underwent annual ultrasound scans. Group 11 (AAA 4-4.9 cm, n = 106) underwent 6-monthly CT scans. Results. We included 352 patients (333 men and 19 women) followed for a mean of 55.2 +/- 37.4 nionths (6.3-199.8). The mean growth rate was significantly greater in group 11 (4,72 +/- 5.93 vs. 2.07 +/- 3.23 mm/4year; p < 0.0001). Group 11 had a greater percentage of patients with rapid aneurysm expansion (> 4 mm/year) (36.8 vs. 13.8%; p < 0.0001). The classical cardiovascular risk factors did not influence the AAA growth rate in group I. Chronic limb ischemia was associated with slower expansion (<= 4 mm/year) (OR 0.47, CI 95% 0.22-0.99; p = 0.045). Diabetic patients in group II had a significantly smaller mean AAA growth rate than non-diabetics (1.69 +/- 3.51 vs. 5.22 +/- 6.11 mm/4year, p = 0.032). Conclusions. The expansion rate of small AAA increases with the AAA size. AAA with a diameter of 3-3.9 cm expand slowly, and they are very unlikely to require surgical repair in 5 years. Many 4-4.9 cm AAA can be expected to reach a surgical size in the first 2 years of follow-up. Chronic limb ischemia and diabetes are associated with reduced aneurysin growth rates.
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关键词
Small abdominal aortic aneurysm,Growth rate,Risk factors
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