Evaluating growth patterns of Abdominal Aortic Aneurysm diam
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Small abdominal aortic aneurysms (AAAs) are common in the elderly population. Based on linear low growth patterns, surveillance of abdominal aortic aneurysms less than 4.25 cm can be safely extended to at least 2 years.

The objective of this recent study published in the JAMA Surgery was to assess the growth patterns and rates of abdominal aortic aneurysms (AAAs) as documented on serial computed tomography (CT) scans.

A cohort study and secondary analysis of the Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (N-TA3CT), a randomized, double-blind placebo-controlled clinical trial conducted with CT imaging every 6 months for 2 years. The trial was a multicenter, observational secondary analysis, not related to treatment hypotheses of data collected in the N-TA3CT. Participants included 254 patients with baseline AAA diameters between 3.5 and 5.0 cm.

A total of 254 patients were included.

--Yearly growth rates of AAA diameters were a median of 0.17 cm/y and a mean, 0.19 cm/y. Ten percent of AAAs displayed minimal to no growth, 62% displayed low growth, and 28% displayed high growth.

--Baseline AAA diameter accounted for 5.4% of the variance of growth rate. Most AAAs displayed linear growth; large variations in interval growth rates occurred infrequently, and some patients’ growth patterns were not clearly classifiable.

--No patients with a maximum transverse diameter less than 4.25 cm exceeded sex-specific repair thresholds at 2 years. 26 percent of patients with a maximum transverse diameter of at least 4.25 cm exceeded sex-specific repair thresholds at 2 years.

In conclusion, Most small AAAs showed linear growth; large intrapatient variations in interval growth rates were infrequently observed over 2 years. Linear growth modeling of AAAs in individual patients suggests smaller AAAs (<4.25 cm) can be followed up with a CT scan in at least 2 years with little chance of exceeding interventional thresholds.

Source: https://jamanetwork.com/journals/jamasurgery/article-abstract/2776432
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