Materiały źródłowe

• #1 Aortic aneurysms: current pathogenesis and therapeutic targets | Experimental & Molecular Medicine

  https://www.nature.com/articles/s12276-023-01130-w

  Aortic aneurysm is a chronic disease characterized by localized expansion of the aorta, including the ascending aorta, arch, descending aorta, and abdominal aorta. […] Aortic aneurysms are estimated to lead to 150,000~200,000 deaths per year worldwide. […] Aortic aneurysm is a chronic aortic disease characterized by permanent localized dilatation of the aorta through adverse remodeling of the aortic wall, and it can subsequently progress to life-threatening consequences through aortic rupture, which has a mortality of over 80% and causes 150,000-200,000 deaths each year worldwide. […] Aortic aneurysms are generally classified as thoracic aortic aneurysms (TAAs), which form in the ascending aorta, the arch, or the aorta above the diaphragm, or abdominal aortic aneurysms (AAAs), which are localized in the aorta below the diaphragm in the supra- or infrarenal regions.

• #2 Aortic aneurysm – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_aneurysm

  According to a review of global data through 2019, the prevalence of abdominal aortic aneurysm worldwide was about 0.9% in people under age 79 years, and is about four times higher in men than in women at any age. Death occurs in about 55-64% of people having rupture of the AAA. […] Screening with ultrasound is indicated in those at high risk. Prevention is by decreasing risk factors, such as smoking, and treatment is either by open or endovascular surgery. Aortic aneurysms resulted in about 152,000 deaths worldwide in 2013, up from 100,000 in 1990. […] Globally, aortic aneurysms resulted in about ~170,000 deaths in 2017. This figure represents an increase from approximately ~100,000 in 1990.

• #3 Patients with Abdominal Aortic Aneurysm (AAA) | Society for Vascular Surgery

  https://vascular.org/node/87

  Every year, 200,000 people in the U.S. are diagnosed with an abdominal aortic aneurysm (AAA), a dilation of the main artery within the abdomen. […] A ruptured AAA is the 15th leading cause of death in the country (~4,500 cases/yr) and the 10th leading cause of death in men older than 55. AAAs occur in up to 13 percent of men and 6 percent of women over the age of 65. […] Because the mortality associated with elective aneurysm repair is drastically lower than following repair of a ruptured AAA, the emphasis must be on early detection and repair prior to the occurrence of rupture. […] Death from AAA is preventable with early detection and appropriate, timely treatment. […] Screening for AAA in specific patient populations has been shown to improve disease mortality and can be done without any patient risk using duplex ultrasound.

• #4 The Global and Regional Prevalence of Abdominal Aortic Aneurysms: A Systematic Review and Modeling Analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36177847/

  Objective: To estimate the global and regional prevalence and cases of abdominal aortic aneurysms (AAAs) in 2019 and to evaluate major associated factors. […] Understanding the global prevalence of AAA is essential for optimizing health services and reducing mortality from reputed AAA. […] We retained 54 articles across 19 countries. The global prevalence of AAA among persons aged 30 to 79 years was 0.92% (95% CI, 0.65-1.30), translating to a total of 35.12 million (95% CI, 24.94-49.80) AAA cases in 2019. […] In 2019, the Western Pacific region had the highest AAA prevalence at 1.31% (95% CI, 0.94-1.85), whereas the African region had the lowest prevalence at 0.33% (95% CI, 0.23-0.48). […] A substantial proportion of people are affected by AAA. There is a need to optimize epidemiological studies to promptly respond to at-risk and identified cases to improve outcomes.

• #5

  https://journals.lww.com/annalsofsurgery/fulltext/2023/06000/the_global_and_regional_prevalence_of_abdominal.9.aspx

  To estimate the global and regional prevalence and cases of abdominal aortic aneurysms (AAAs) in 2019 and to evaluate major associated factors. […] Understanding the global prevalence of AAA is essential for optimizing health services and reducing mortality from reputed AAA. […] We retained 54 articles across 19 countries. The global prevalence of AAA among persons aged 30 to 79 years was 0.92% (95% CI, 0.651.30), translating to a total of 35.12 million (95% CI, 24.9449.80) AAA cases in 2019. […] Smoking, male sex, family history of AAA, advanced age, hypertension, hypercholesterolemia, obesity, cardiovascular disease, cerebrovascular disease, claudication, peripheral artery disease, pulmonary disease, and renal disease were associated with AAA. […] In 2019, the Western Pacific region had the highest AAA prevalence at 1.31% (95% CI, 0.941.85), whereas the African region had the lowest prevalence at 0.33% (95% CI, 0.230.48).

• #6 Epidemiology, risk factors, pathogenesis, and natural history of abdominal aortic aneurysm – UpToDate

  https://www.uptodate.com/contents/epidemiology-risk-factors-pathogenesis-and-natural-history-of-abdominal-aortic-aneurysm

  Epidemiology, risk factors, pathogenesis, and natural history of abdominal aortic aneurysm […] The epidemiology, risk factors, pathogenesis, and natural history of AAA are reviewed here. The prevalence of abdominal aortic aneurysm (AAA) is 3 to 8 percent in screening studies, affecting predominantly males. However, AAAs found on screening are generally small; those measuring ≥5.5 cm or greater are found in only 0.4 to 0.6 percent of those screened. Because the incidence of AAA rises sharply in individuals over 60 years of age, the future prevalence of AAA could increase substantially in association with the aging population. On the other hand, some suggest that a reduction in the prevalence of smoking could have the opposite effect, with several studies citing a lower prevalence of AAA in 65- to 80-year-old White adults.

• #7 The Global and Regional Prevalence of Abdominal Aortic Aneurysms: A Systematic Review and Modeling Analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36177847/

  Objective: To estimate the global and regional prevalence and cases of abdominal aortic aneurysms (AAAs) in 2019 and to evaluate major associated factors. […] Understanding the global prevalence of AAA is essential for optimizing health services and reducing mortality from reputed AAA. […] We retained 54 articles across 19 countries. The global prevalence of AAA among persons aged 30 to 79 years was 0.92% (95% CI, 0.65-1.30), translating to a total of 35.12 million (95% CI, 24.94-49.80) AAA cases in 2019. […] In 2019, the Western Pacific region had the highest AAA prevalence at 1.31% (95% CI, 0.94-1.85), whereas the African region had the lowest prevalence at 0.33% (95% CI, 0.23-0.48). […] A substantial proportion of people are affected by AAA. There is a need to optimize epidemiological studies to promptly respond to at-risk and identified cases to improve outcomes.

• #8

  https://journals.lww.com/annalsofsurgery/fulltext/2023/06000/the_global_and_regional_prevalence_of_abdominal.9.aspx

  To estimate the global and regional prevalence and cases of abdominal aortic aneurysms (AAAs) in 2019 and to evaluate major associated factors. […] Understanding the global prevalence of AAA is essential for optimizing health services and reducing mortality from reputed AAA. […] We retained 54 articles across 19 countries. The global prevalence of AAA among persons aged 30 to 79 years was 0.92% (95% CI, 0.651.30), translating to a total of 35.12 million (95% CI, 24.9449.80) AAA cases in 2019. […] Smoking, male sex, family history of AAA, advanced age, hypertension, hypercholesterolemia, obesity, cardiovascular disease, cerebrovascular disease, claudication, peripheral artery disease, pulmonary disease, and renal disease were associated with AAA. […] In 2019, the Western Pacific region had the highest AAA prevalence at 1.31% (95% CI, 0.941.85), whereas the African region had the lowest prevalence at 0.33% (95% CI, 0.230.48).

• #9 Abdominal Aortic Aneurysm: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/7153-abdominal-aortic-aneurysm

  Abdominal aortic aneurysms are a common condition. […] They occur in about 1.4% of adults between the ages of 50 and 84 in the U.S. This is around 1.1 million people. […] They occur in between 1% and 2% of males over age 65. With each additional decade of life the risk of developing an AAA doubles. […] Theyre four times more common in males. […] They occur in about 1% of females over 70 with a history of smoking. […] Aneurysms can form anywhere along your aorta, but they usually form in your belly. Abdominal aortic aneurysms represent about 75% of all aortic aneurysms. […] AAAs are more common among white people compared to Black people and Asian people. […] AAAs most often affect people males. But when they form in females, they have a higher risk of rupturing at smaller sizes as well as occurring in family members.

• #10 Abdominal aortic aneurysm epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Abdominal_aortic_aneurysm_epidemiology_and_demographics

  Abdominal aortic aneurysm is the 13th leading cause of death in the US. Abdominal aortic aneurysms are more common in developed countries. Elderly, caucasian males who are smokers are at a higher risk for developing an abdominal aortic aneurysm. […] The incidence of abdominal aortic aneurysms increases after age 60 and peaks in the seventh and eighth decades of life. […] The prevalence among males over 60 years is 2000-6000/100,000. […] Abdominal aortic aneurysms (AAA) is a disease of the elderly, and is the 10th leading cause of death in older men in the United States. […] An individual’s risk of AAA increases by 6% per decade of life. […] Rupture of the AAA occurs in 1-3% of men aged 65 or more with an associated mortality rate of 70-95%. […] AAA tends to cluster in families, therefore affecting younger members of families in the absence of traditional acquired risk factors.

• #11 Incidence and Prevalence of Thoracic Aortic Aneurysms: A Systematic Review and Meta-analysis of Population-Based Studies – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33705940/

  Thoracic aortic aneurysms (TAA) may grow asymptomatically until they rupture, with a mortality over 90%. The true incidence and prevalence of this condition is uncertain and epidemiologic data is scarce, understudied and dispersed. Therefore, we aimed to conduct a systematic review and meta-analysis of the incidence and prevalence of TAAs in population-based studies. […] The pooled incidence and prevalence of TAAs was 5.3 per 100,000 individuals/year (95% confidence interval [CI]: 3.0; 8.3) and 0.16% (95% CI: 0.12; 0.20), respectively. The pooled incidence of ruptured aneurysms was 1.6 per 100,000 individuals/year (95% CI: 1.3; 2.1). […] The current epidemiologic information provided serve as a base for future public-health decisions. The lack of well-design population-base studies and the limitations encountered serve as calling for future research in this field.

• #12 Thoracic Aortic Aneurysm: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/424904-overview

  Although findings from autopsy series have varied widely, the prevalence of aortic aneurysms probably exceeds 3-4% in individuals older than 65 years. Aortic aneurysms are more common in men than in women and are more common in persons with COPD than in those without lung disease. […] The incidence of TAAs has been estimated to be about 6 cases per 100,000 person-years. In a systematic review and meta-analysis of the incidence and prevalence of TAAs in 22 population-based studies, Melo et al found a pooled incidence of 5.3 per 100,000 individuals per year and a prevalence of 0.16%. […] Death from aneurysmal rupture has been one of the 15 leading causes of death in most series. In addition, the overall prevalence of aortic aneurysms has increased significantly in the past 30 years. This is partly due to an increase in diagnosis based on the widespread use of imaging techniques. However, the prevalence of fatal and nonfatal rupture has also increased, suggesting a true increase in prevalence.

• #13 Thoracic Aneurysm: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/761627-overview

  The incidence of aortic aneurysm is 5.9 cases per 100,000 person-years. […] Thoracic aortic aneurysm is most common among whites. […] Men are affected 2-4 times more frequently than women; however, women have been found to have worse outcomes. […] The mean patient age at diagnosis is 60-65 years.

• #14 Thoracic aortic aneurysm epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Thoracic_aortic_aneurysm_epidemiology_and_demographics

  Thoracic aortic aneurysms are relatively uncommon (6 to 10 new ones per 100,000 person years) and are less prevalent than abdominal aortic aneurysm. Thoracic aortic aneurysms are generally diagnosed after the sixth and seventh decades of life. Although men are affected 2 to 4 times as often as women, women are at higher risk of rupture by a factor 6.8. […] TAAs are relatively uncommon with an estimated incidence between 6 and 10 new aneurysms per 100,000 person-years. According to a study by Beckerstaff et al., the incidence of thoracic aortic aneurysms was reported to be 5.3 per 100,000 per year. Another study done by Clouse et al. showed the incidence to be 10.4 per 100,000 per year. […] However, the incidence and prevalence of TAD has been increasing in the past years. The annual number of surgeries performed on the aorta have increased, along with improved post-surgical and long term survival. […] TAAs are usually diagnosed after the sixth and seventh decade of life. […] Males are affected approximately two to four times more often than females. […] Thoracic aortic aneurysm is more common in caucasians.

• #15 Abdominal Aortic Aneurysm | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0415/p538.html

  Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. The natural history of AAA shows that as aneurysms increase in size, they expand at a greater rate and the risk of rupture increases. Therefore, in persons found to have aneurysms on initial screening, regular surveillance is needed every six months to three years, depending on aneurysm size. Current guidelines do not advocate rescreening persons with an aortic diameter smaller than 3.0 cm.

• #16 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  Important risk factors for AAA include older age, male sex, smoking, and having a first-degree relative with an AAA. […] Epidemiologic literature commonly defines an ever smoker as someone who has smoked 100 or more cigarettes. […] Indirect evidence shows that smoking is the strongest predictor of AAA prevalence, growth, and rupture rates. […] Family history of AAA in a first-degree relative doubles the risk of developing AAA. […] The primary method of screening for AAA is conventional abdominal duplex ultrasonography. […] Evidence is adequate to support 1-time screening for men who have ever smoked. […] The majority of screen-detected AAAs (90%) are between 3.0 and 5.5 cm in diameter and thus below the usual threshold for surgery. […] The current standard of care for patients with stable smaller aneurysms is to maintain ultrasound surveillance at regular intervals because the risk of rupture is small.

• #17 Pathophysiology and epidemiology of abdominal aortic aneurysms | Nature Reviews Cardiology

  https://www.nature.com/articles/nrcardio.2010.180

  Abdominal aortic aneurysms (AAAs) are found in up to 8% of men aged 65 years, yet usually remain asymptomatic until they rupture. […] Rupture of an AAA and its associated catastrophic physiological insult carries overall mortality in excess of 80%, and 2% of all deaths are AAA-related. […] Risk factors for AAAs include increasing age, male sex, smoking, and low HDL-cholesterol levels. […] Screening programs target men aged 65 years, as this group is at highest risk of developing an abdominal aortic aneurysm. […] Endovascular repair has substantially reduced perioperative morbidity and mortality of abdominal aortic aneurysms. […] Centralization of vascular surgical services has led to improved outcomes among patients with an abdominal aortic aneurysm.

• #18 Abdominal aortic aneurysm epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Abdominal_aortic_aneurysm_epidemiology_and_demographics

  Abdominal aortic aneurysm is the 13th leading cause of death in the US. Abdominal aortic aneurysms are more common in developed countries. Elderly, caucasian males who are smokers are at a higher risk for developing an abdominal aortic aneurysm. […] The incidence of abdominal aortic aneurysms increases after age 60 and peaks in the seventh and eighth decades of life. […] The prevalence among males over 60 years is 2000-6000/100,000. […] Abdominal aortic aneurysms (AAA) is a disease of the elderly, and is the 10th leading cause of death in older men in the United States. […] An individual’s risk of AAA increases by 6% per decade of life. […] Rupture of the AAA occurs in 1-3% of men aged 65 or more with an associated mortality rate of 70-95%. […] AAA tends to cluster in families, therefore affecting younger members of families in the absence of traditional acquired risk factors.

• #19 Abdominal aortic aneurysm epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Abdominal_aortic_aneurysm_epidemiology_and_demographics

  Abdominal aortic aneurysm is 5 times more common in men than women. […] The disease tends to affect older Caucasian males and is 3.5 times more common in Caucasian men than in African-American men. […] In the US, the incidence of abdominal aortic aneurysm is 2-4% in the adult population. […] Abdominal aortic aneurysm is uncommon in individuals of African, African American, Asian and Hispanic heritage. […] The frequency of abdominal aortic aneurysm is much higher in smokers than in non-smokers (8:1).

• #20

  https://journals.lww.com/annalsofsurgery/fulltext/2023/06000/the_global_and_regional_prevalence_of_abdominal.9.aspx

  In 2019, the prevalence of AAA in people aged 30 to 79 years globally was 0.92% (95% CI, 0.651.30). […] It was 3.7-times greater in males than in females. […] After applying the demographic profile in 2019, these translated to a total of 35.12 million (95% CI, 24.9449.80) people aged 30 to 79 years that were living with AAA in 2019. […] Among the affected cases, around 79% were males. […] The age-specific and sex-specific prevalence rates of AAA at the global level are listed in Table 1. […] Advanced age, male sex, hypertension, hypercholesterolemia, obesity, smoking (ever, former or current), family history of AAA, CVD, cerebrovascular disease, claudication, peripheral artery disease, pulmonary disease, and renal disease were all revealed to be significantly associated with a higher odds of AAA.

• #21 Epidemiology, risk factors, pathogenesis, and natural history of abdominal aortic aneurysm – UpToDate

  https://www.uptodate.com/contents/epidemiology-risk-factors-pathogenesis-and-natural-history-of-abdominal-aortic-aneurysm

  The annual incidence of new AAA diagnoses is approximately 0.4 to 0.67 percent in Western populations. This equates to 2.5 to 6.5 aneurysms per 1000 person-years. Age significantly impacts the incidence. As an example, in one study, among males aged 65 to 74 years, the incidence was 55 per 100,000 person-years, increasing to 112 per 100,000 person-years for males aged 75 to 85 years, and further increasing to 298 per 100,000 person-years for those older than 85. […] The incidence of AAA discovery may be decreasing, however. In a screening study that included 81,150 men, the overall prevalence of screen-detected AAA (diameter >3.0 cm) was 3.4 percent, decreasing from 5.0 percent in 1991 to 1.3 percent in 2015. AAA expansion rates were unchanged. Among males who initially had a subaneurysmal aorta (2.6 to 2.9 cm), 57.6 percent were estimated to develop an AAA of ≥3.0 cm within 5 years of the initial scan, and 28.0 percent to develop a large AAA (>5.5 cm) within 15 years.

• #22 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AAA with ultrasonography in women aged 65 to 75 years who have ever smoked or have a family history of AAA. […] An AAA is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. […] The prevalence of AAA has declined over the past 2 decades among screened men 65 years or older in various countries such as the United Kingdom, New Zealand, Sweden, and Denmark. […] Population-based studies in men older than 60 years have found an AAA prevalence ranging from 1.2% to 3.3%. […] The reduction in prevalence is attributed to the decrease in smoking prevalence over time. […] The current prevalence of AAA in the United States is unclear because of the low uptake of screening.

• #23

  https://journals.lww.com/annalsofsurgery/fulltext/2023/06000/the_global_and_regional_prevalence_of_abdominal.9.aspx

  A substantial proportion of people are affected by AAA. There is a need to optimize epidemiological studies to promptly respond to at-risk and identified cases to improve outcomes. […] Epidemiological reports on AAA vary across age, sex, and locations worldwide. […] Most studies have identified advanced age, male sex, ever smoking, high blood pressure, and family history of AAA as the most important risk factors driving the burden of AAA. […] In 2017, the Global Burden of Disease (GBD) collaborators reported that AAA accounted for ~170,000 deaths and 3 million disability-adjusted life years worldwide. […] Despite these figures, the true global burden of AAA remains vague. […] Some authors noted that, despite a seemingly decreasing trend in AAA, prevalence and mortality in settings across Latin America, Asia Pacific, and Africa may be increasing.

• #24 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  Aneurysm of the thoracic aorta is less common than in the abdominal aorta, but it is clinically important because of the risk of rupture and death. […] Surveillance with various imaging tests is critical before and after intervention to guide treatment. […] Guidelines from several professional societies are available regarding surveillance and indications for intervention. […] Regular imaging surveillance is critical after diagnosis and after aneurysm interventions. […] There are no effective preventive strategies for TAA to date; thus, early detection, surveillance, and treatment are critical to improving outcomes. Guidelines are available. […] Most cases of TAA are asymptomatic and are discovered either incidentally on imaging or as part of dedicated screening for those at risk.

• #25 Updates on AAA screening and surveillance

  https://www1.racgp.org.au/ajgp/2018/may/aaa-screening-and-surveillance

  On the basis of evidence showing substantial benefit, the US Preventive Services Task Force (USPSTF) recommends one-time ultrasonography screening for men aged 65-75 years who have ever smoked. […] The justification for screening programs has been further revisited by the publication of a 2017 meta-analysis of all reported trials, which concluded that screening reduces AAA-related deaths (odds ratio [OR] 0.66, 95% CI: 0.47, 0.93, P 0.02). […] While aortic aneurysm surveillance is generally recommended on the basis of maximal aortic diameter, it is recognised that this is merely a crude surrogate marker for rupture risk. […] Current research explores materials modelling, computational fluid dynamics and finite element analysis in order to predict how aneurysms will grow and the potential location and timing of rupture.

• #26 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. […] The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked. […] The USPSTF recommends that clinicians selectively offer screening for AAA with ultrasonography in men aged 65 to 75 years who have never smoked rather than routinely screening all men in this group. […] Evidence indicates that the net benefit of screening all men in this group is small. […] The USPSTF recommends against routine screening for AAA with ultrasonography in women who have never smoked and have no family history of AAA.

• #27 Patients with Abdominal Aortic Aneurysm (AAA) | Society for Vascular Surgery

  https://vascular.org/node/87

  Every year, 200,000 people in the U.S. are diagnosed with an abdominal aortic aneurysm (AAA), a dilation of the main artery within the abdomen. […] A ruptured AAA is the 15th leading cause of death in the country (~4,500 cases/yr) and the 10th leading cause of death in men older than 55. AAAs occur in up to 13 percent of men and 6 percent of women over the age of 65. […] Because the mortality associated with elective aneurysm repair is drastically lower than following repair of a ruptured AAA, the emphasis must be on early detection and repair prior to the occurrence of rupture. […] Death from AAA is preventable with early detection and appropriate, timely treatment. […] Screening for AAA in specific patient populations has been shown to improve disease mortality and can be done without any patient risk using duplex ultrasound.

• #28 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. […] The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked. […] The USPSTF recommends that clinicians selectively offer screening for AAA with ultrasonography in men aged 65 to 75 years who have never smoked rather than routinely screening all men in this group. […] Evidence indicates that the net benefit of screening all men in this group is small. […] The USPSTF recommends against routine screening for AAA with ultrasonography in women who have never smoked and have no family history of AAA.

• #29 Abdominal Aortic Aneurysm | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0415/p538.html

  Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. The natural history of AAA shows that as aneurysms increase in size, they expand at a greater rate and the risk of rupture increases. Therefore, in persons found to have aneurysms on initial screening, regular surveillance is needed every six months to three years, depending on aneurysm size. Current guidelines do not advocate rescreening persons with an aortic diameter smaller than 3.0 cm.

• #30 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. […] The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked. […] The USPSTF recommends that clinicians selectively offer screening for AAA with ultrasonography in men aged 65 to 75 years who have never smoked rather than routinely screening all men in this group. […] Evidence indicates that the net benefit of screening all men in this group is small. […] The USPSTF recommends against routine screening for AAA with ultrasonography in women who have never smoked and have no family history of AAA.

• #31 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AAA with ultrasonography in women aged 65 to 75 years who have ever smoked or have a family history of AAA. […] An AAA is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. […] The prevalence of AAA has declined over the past 2 decades among screened men 65 years or older in various countries such as the United Kingdom, New Zealand, Sweden, and Denmark. […] Population-based studies in men older than 60 years have found an AAA prevalence ranging from 1.2% to 3.3%. […] The reduction in prevalence is attributed to the decrease in smoking prevalence over time. […] The current prevalence of AAA in the United States is unclear because of the low uptake of screening.

• #32 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. […] The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked. […] The USPSTF recommends that clinicians selectively offer screening for AAA with ultrasonography in men aged 65 to 75 years who have never smoked rather than routinely screening all men in this group. […] Evidence indicates that the net benefit of screening all men in this group is small. […] The USPSTF recommends against routine screening for AAA with ultrasonography in women who have never smoked and have no family history of AAA.

• #33

  https://www.gov.uk/government/publications/aaa-screening-programmes-in-the-uk-10-year-effectiveness-review/uk-aaa-screening-programmes-10-year-effectiveness-review

  The main finding of this review is the steady decline in deaths in men from rAAA during the decade of study. […] The screening programme itself has been shown to be effective. Almost 3.5 million men have been invited for screening, with an uptake of around 80% – higher than almost all the adult national screening programmes. […] The question is, how much of the reduction in death from rAAA is due to screening and how much is due to changes in disease prevalence and other improvements in healthcare? […] The best evidence comes from the NVR, where the reduction in the number of rAAA was by approximately two thirds in the screened cohort and only a half in the non-screened cohort. […] NHS AAA screening programmes are effective at identifying men with AAA and referring men for treatment. […] NHS AAA screening programmes remain cost effective at NICE willingness to pay thresholds, despite falling prevalence in 65-year-old men.

• #34

  https://www.gov.uk/government/publications/aaa-screening-programmes-in-the-uk-10-year-effectiveness-review/uk-aaa-screening-programmes-10-year-effectiveness-review

  The aim of this report was to assess the effectiveness of population screening for AAA in men aged 65, by reviewing the AAA screening programmes across the UK between 2013 and 2023. […] The aim was to review the data collected by the 4 UK programmes in England, Scotland, Wales and Northern Ireland. Additionally, national statistics were obtained from the 4 nations on admissions to hospital for rAAA and deaths recorded with an underlying cause of rAAA. […] The AAA screening programmes in the UK aim to reduce AAA-related deaths in men by identifying aneurysms at a stage before rupture is likely to have occurred. Surveillance and treatment can then be offered at the appropriate stage to reduce the risk of AAA rupture, emergency hospital treatment, and death. […] It can be concluded that the AAA screening programmes in the UK are effective and contribute substantially to ongoing reductions in AAA-related mortality (deaths).

• #35 Updates on AAA screening and surveillance

  https://www1.racgp.org.au/ajgp/2018/may/aaa-screening-and-surveillance

  At this time, maximal aortic diameter remains the primary surveillance tool; however, significant nuance exists in the determination of this measurement. […] In general, suggested surveillance intervals have been based on rupture risk and expected growth rates, estimated from the size of the aneurysm. […] The risk of graft failure and disease progression necessitates ongoing surveillance following EVAR. Tailored surveillance programs are used to minimise the resources allocated to ongoing surveillance. However, it is accepted that surveillance is paramount for long-lasting success with EVAR.

• #36 Abdominal Aortic Aneurysm | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/abdominal-aortic-aneurysm.html

  Abdominal aortic aneurysm is a pathologic condition with progressive abdominal aortic dilatation of 3.0 cm or more that predisposes the abdominal aorta to rupture. […] The risk factors for abdominal aortic aneurysm include hypertension, coronary artery disease, tobacco use, male sex, a family history of abdominal aortic aneurysm, age older than 65 years, and peripheral artery disease. […] Surveillance of abdominal aortic aneurysm depends on the size and growth rate of the aneurysm. […] Although definitive recommendations and evidence for AAA surveillance are lacking, the American College of Cardiology/American Heart Association and the Society for Vascular Surgery provide guidance based on the size of the aneurysm. […] The risk of growth increases with aneurysm size. […] Therefore, it is reasonable to repeat ultrasonography for aneurysms with a diameter of 3.0 cm to 3.9 cm every two to three years, and every six to 12 months for aneurysms 4.0 cm to 4.9 cm.

• #37 Patients with Abdominal Aortic Aneurysm (AAA) | Society for Vascular Surgery

  https://vascular.org/node/87

  We recommend a one-time ultrasound screening for AAAs in men or women 65 to 75 years of age with a history of tobacco use. […] We suggest surveillance imaging at 3-year intervals for patients with an AAA between 3.0 and 3.9 cm. […] We suggest surveillance imaging at 12-month intervals for patients with an AAA of 4.0 to 4.9 cm in diameter. […] We suggest surveillance imaging at 6-month intervals for patients with an AAA between 5.0 and 5.4 cm in diameter. […] We recommend a CT scan to evaluate patients thought to have AAA presenting with recent-onset abdominal or back pain, particularly in the presence of a pulsatile epigastric mass or significant risk factors for AAA. […] Referral to a vascular surgeon is recommended at the time of AAA diagnosis. […] We recommend repair for the patient who presents with an AAA and abdominal or back pain that is likely to be attributed to the aneurysm.

• #38

  https://www.gov.uk/government/publications/abdominal-aortic-aneurysm-screening-pathway-requirements-specification/abdominal-aortic-aneurysm-screening-pathway-requirements-specification

  This publication provides an overview of the NHS abdominal aortic aneurysm (AAA) screening programme by describing what should happen at each stage of the pathway. […] The NHS offers an ultrasound scan to men during the screening year (1 April to 31 March) in which they turn 65. […] The purpose of the programme is to identify any swelling in the aorta at an early stage to reduce deaths from AAAs. […] Men are placed under surveillance if they are found to have a small or medium aneurysm, to see if the aneurysm increases in size. […] Surveillance requirements relate to the process of scanning men with aneurysms between 3cm to 5.4cm to check if their AAAs are getting bigger. Providers should have systems in place to: offer yearly surveillance scans to men with small aneurysms, and every 3 months to men with medium size aneurysms.

• #39 Recommendations | Abdominal aortic aneurysm: diagnosis and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng156/chapter/recommendations

  Inform all men aged 66 or over who have not already been screened about the NHS abdominal aortic aneurysm (AAA) screening programme, and advise them that they can self-refer. […] Encourage men aged 66 or over to self-refer to the NHS AAA screening programme if they have not already been screened and they have any of the following risk factors: […] Be aware that people of European family origin are at a higher risk of an AAA. […] Offer surveillance with aortic ultrasound to people with an asymptomatic AAA. Use the same surveillance frequency as the NHS AAA screening programme. […] Be aware that there is no evidence that any single symptom, sign or prognostic risk assessment tool can be used to determine whether people with a suspected or confirmed ruptured abdominal aortic aneurysm (AAA) should be transferred to a regional vascular service.

• #40 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  CTA or MRA is useful at baseline to image the entire aorta and check agreement with TTE measurements. […] If there is poor agreement between TTE and CTA or MRA measurements, or poor visualization of the aorta with TTE, then CTA or MRA should be used instead for regular monitoring. […] Patients with TAA should be referred to a cardiologist (and a surgeon, if approaching or exceeding surgical criteria) for optimal decision-making in surveillance and management. […] The first thing to consider is the imaging modality to use. […] Accurate and reproducible measurements are critical in surveillance, especially when nearing the threshold for intervention. […] An early follow-up scan (6 months after initial TAA diagnosis) is recommended to assess for growth of the aneurysm in patients who have genetic conditions, and annually thereafter if measurements have been stable or more frequently if there is accelerated growth. […] Early detection of TAAs with surveillance and intervention have the potential to improve outcomes for patients and family members.

• #41 Integrated Aortic Program | Thoracic Aneurysm Program

  https://www.valleyhealth.com/services/integrated-aortic-program

  Living with an aortic aneurysm can be stressful, but when managed properly, patients can enjoy an excellent quality of life. […] Our well-established diagnostic, surgical and surveillance program offers comprehensive care for patients with aortic aneurysm. […] A person may be screened for an aneurysm if they have a family history of thoracic aneurysms or connective tissue disease. […] Most patients do not need surgery, and their aneurysm can be safely managed using surveillance and medical follow-up. […] Valley currently has over 1,700 patients under surveillance in the program, ranging from 17 to 90 years of age. […] The First-Degree Relative program provides screening, imaging and long-term surveillance for those individuals who have a relative diagnosed with a thoracic aneurysm.

• #42 Smidt Heart Institute Opens Aortic Surveillance Clinic

  https://www.cedars-sinai.org/newsroom/smidt-heart-institute-opens-aortic-surveillance-clinic/

  Experts at the Smidt Heart Institute’s new Aortic Surveillance Clinic will monitor patients with aortic aneurysms or enlarged aortas. The Smidt Heart Institute at Cedars-Sinai has opened an Aortic Surveillance Clinic for the evaluation and long-term monitoring of patients with enlarged aortas, or aortic aneurysms, for whom surgery may not be necessary. Through the Aortic Surveillance Clinic, we offer reassurance that they are being carefully and closely monitored and that proper therapy, including surgery, will be offered if needed. Aortic surgeons know that over time, they will accumulate hundreds of patients with aneurysms that they are following and not operating on. Careful monitoring of a significantly enlarged aorta, or aortic aneurysm, can help prevent the possibility of a life-threatening condition, such as aortic dissection. The Aortic Surveillance Clinic also provides expert care for patients with certain genetic syndromes, such as connective tissue disorders like Marfan syndrome and Loeys-Dietz syndrome, as well as other genetic disorders affecting the aorta and aortic valve. We are pleased to have the ability to focus on a subset of patients when they don’t need surgery and educate them on how to prevent acute aortic events, which can be fatal.

• #43 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  CTA or MRA is useful at baseline to image the entire aorta and check agreement with TTE measurements. […] If there is poor agreement between TTE and CTA or MRA measurements, or poor visualization of the aorta with TTE, then CTA or MRA should be used instead for regular monitoring. […] Patients with TAA should be referred to a cardiologist (and a surgeon, if approaching or exceeding surgical criteria) for optimal decision-making in surveillance and management. […] The first thing to consider is the imaging modality to use. […] Accurate and reproducible measurements are critical in surveillance, especially when nearing the threshold for intervention. […] An early follow-up scan (6 months after initial TAA diagnosis) is recommended to assess for growth of the aneurysm in patients who have genetic conditions, and annually thereafter if measurements have been stable or more frequently if there is accelerated growth. […] Early detection of TAAs with surveillance and intervention have the potential to improve outcomes for patients and family members.

• #44 Abdominal aortic aneurysm | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/abdominal-aortic-aneurysm?lang=us

  Abdominal aortic aneurysms represent the tenth most common cause of death in the Western world: […] prevalence increases with age […] ~10% of patients older than 65 years have an AAA […] males are much more commonly affected than females (4:1 male/female ratio). […] Imaging has a crucial role in diagnosis and active surveillance. […] Ultrasound is optimal for general AAA screening and surveillance because it is fast, spares the use of ionizing radiation and intravenous contrast, and is relatively inexpensive. […] The natural history of abdominal aortic aneurysms is variable. Some small aneurysms do not appear to change, while others slowly expand and become at risk for eventual rupture. […] In terms of imaging, there remains debate about the best criteria for predicting AAA rupture and, therefore, indications for operative intervention. […] Recommended imaging follow-up intervals for enlarged infrarenal abdominal aorta vary by organization.

• #45 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  The estimated prevalence of AAA in women is reportedly less than that in men. […] Operative mortality associated with AAA is higher in women than in men. […] Evidence is insufficient to accurately characterize current practice patterns related to screening for AAA in women. […] This recommendation incorporates new evidence and replaces the 2014 USPSTF recommendation. […] The USPSTF examined evidence regarding the effectiveness of 1-time and repeated screening for AAA, the associated harms of screening, and the benefits and harms of available treatments for small AAAs (3.0-5.4 cm in diameter) identified through screening. […] Ultrasonography is the primary method used to screen for AAA in primary care because of its high sensitivity (94%-100%) and specificity (98%-100%). […] Each of the 4 older screening trials and a more recent population-based screening RCT showed an increase in elective operations in the intervention vs control group.

• #46 Postoperative Abdominal Aortic Aneurysm (AAA) Surveillance < Yale School of Medicine

  https://medicine.yale.edu/news-article/publication-and-the-pi-postoperative-abdominal-aortic-aneurysm-surveillance/

  Yale Department of Surgerys Edouard Aboian, MD, evaluated abdominal aortic aneurysm surveillance in postoperative settings. […] We compared the standard for postoperative abdominal aortic aneurysm surveillance, maximum aortic diameter, to volumetric analysis of abdominal aortic aneurysm. […] The change of volume was more sensitive compared to diameter change, especially after endovascular abdominal aortic aneurysm repair. […] Our volumetric aneurysm analysis confers that you can detect that and potentially intervene early on. […] Volumetric evaluation has less interobserver variability compared to maximum diameter because diameter can be measured in different planes, oftentimes not orthogonal to the centerline of flow, and that may introduce some false findings in aortic aneurysm behavior. […] We are developing predictive clinical tools for a more sensitive analysis of aneurysm post intervention.

• #47 The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance

  https://www.mdpi.com/2077-0383/13/1/193

  There has been a debate about whether maximum diameter can be solely used to assess the natural history of abdominal aortic aneurysm. […] The current literature appears to reinforce the role of volume as a supplementary measure for evaluating the natural history of AAA, in both intact AAAs and after EVAR. […] The clinical impact of AAA volume measurements remains unclear. Several studies show that volumetric analysis can assess changes in AAAs and predict successful endoluminal exclusion after EVAR more accurately than diameter. […] The monitoring of AAAs is mostly targeted to the sequential measurement of maximum abdominal aortic aneurysm diameter. […] Measuring aneurysm volume has also been proposed to possibly add to AAA assessment and improve growth prediction and help in treatment strategies.

• #48 How a new abdominal aortic aneurysm surveillance program saves patients’ lives

  https://health.ucdavis.edu/news/headlines/how-a-new-abdominal-aortic-aneurysm-surveillance-program-saves-patients-lives/2023/02

  Aneurysms discovered prior to rupture need to be measured, closely monitored and evaluated for treatment. […] Efforts like our new surveillance program are saving lives, Kwong added. Being able to catch patients like Tim, who had aneurysms that were detected and who were not receiving follow-up care for whatever reason, allows us to treat their aneurysms when they are smaller and before they have ruptured. This makes their procedures much less complex and minimizes their risk of death. […] In collaboration with AI software company Illuminate, UC Davis Health began its centralized abdominal aortic aneurysm surveillance program in June 2022. The program identifies at-risk abdominal aortic aneurysm (AAA) patients who may have been lost-to-follow-up because they missed care during the pandemic or other factors.

• #49 Abdominal aortic aneurysm surveillance program saving lives

  https://health.ucdavis.edu/news/headlines/abdominal-aortic-aneurysm-surveillance-program-saving-lives/2022/11

  UC Davis Health and AI (artificial intelligence) software company Illuminate have developed a centralized abdominal aortic aneurysm surveillance program that is saving lives. The effort identifies at-risk abdominal aortic aneurysm (AAA) patients who may have been lost-to-follow-up because they missed care during the pandemic or other factors. […] In its first six months, the program has identified over 11,000 patients with some mention of AAA who could benefit from monitoring. […] According to the Society for Vascular Surgery, each year 200,000 people in the United States are diagnosed with an AAA. A ruptured AAA is the 15th leading cause of death in the country and the 10th leading cause of death in men older than 55.

• #50 How a new abdominal aortic aneurysm surveillance program saves patients’ lives

  https://health.ucdavis.edu/news/headlines/how-a-new-abdominal-aortic-aneurysm-surveillance-program-saves-patients-lives/2023/02

  Aneurysms discovered prior to rupture need to be measured, closely monitored and evaluated for treatment. […] Efforts like our new surveillance program are saving lives, Kwong added. Being able to catch patients like Tim, who had aneurysms that were detected and who were not receiving follow-up care for whatever reason, allows us to treat their aneurysms when they are smaller and before they have ruptured. This makes their procedures much less complex and minimizes their risk of death. […] In collaboration with AI software company Illuminate, UC Davis Health began its centralized abdominal aortic aneurysm surveillance program in June 2022. The program identifies at-risk abdominal aortic aneurysm (AAA) patients who may have been lost-to-follow-up because they missed care during the pandemic or other factors.

• #51 The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance

  https://www.mdpi.com/2077-0383/13/1/193

  There has been a debate about whether maximum diameter can be solely used to assess the natural history of abdominal aortic aneurysm. […] The current literature appears to reinforce the role of volume as a supplementary measure for evaluating the natural history of AAA, in both intact AAAs and after EVAR. […] The clinical impact of AAA volume measurements remains unclear. Several studies show that volumetric analysis can assess changes in AAAs and predict successful endoluminal exclusion after EVAR more accurately than diameter. […] The monitoring of AAAs is mostly targeted to the sequential measurement of maximum abdominal aortic aneurysm diameter. […] Measuring aneurysm volume has also been proposed to possibly add to AAA assessment and improve growth prediction and help in treatment strategies.

• #52 The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance

  https://www.mdpi.com/2077-0383/13/1/193

  The current literature appears to reinforce the role of volume as an additional criterion for assessing the natural history of AAAs, both intact and after EVAR. […] Currently, society guidelines recommend the maximum aortic diameter as the only solid indication for AAA treatment. […] However, not all large aneurysms rupture, while sometimes small aneurysms may rupture, even with a maximum diameter < 5.5 cm. [...] In a recent analysis of small AAAs, Olson et al. found that aneurysm volumes that reached the diameter repair threshold ranged from 102 cm³ to 142 cm³ in females and from 105 cm³ to 229 cm³ in males. [...] This significant overlap of the volumes for patients above or below the repair diameter threshold really questions the potential of volume measurements to guide the need for intervention.

• #53 Postoperative Abdominal Aortic Aneurysm (AAA) Surveillance < Yale School of Medicine

  https://medicine.yale.edu/news-article/publication-and-the-pi-postoperative-abdominal-aortic-aneurysm-surveillance/

  Yale Department of Surgerys Edouard Aboian, MD, evaluated abdominal aortic aneurysm surveillance in postoperative settings. […] We compared the standard for postoperative abdominal aortic aneurysm surveillance, maximum aortic diameter, to volumetric analysis of abdominal aortic aneurysm. […] The change of volume was more sensitive compared to diameter change, especially after endovascular abdominal aortic aneurysm repair. […] Our volumetric aneurysm analysis confers that you can detect that and potentially intervene early on. […] Volumetric evaluation has less interobserver variability compared to maximum diameter because diameter can be measured in different planes, oftentimes not orthogonal to the centerline of flow, and that may introduce some false findings in aortic aneurysm behavior. […] We are developing predictive clinical tools for a more sensitive analysis of aneurysm post intervention.

• #54 Postoperative Abdominal Aortic Aneurysm (AAA) Surveillance < Yale School of Medicine

  https://medicine.yale.edu/news-article/publication-and-the-pi-postoperative-abdominal-aortic-aneurysm-surveillance/

  Yale Department of Surgerys Edouard Aboian, MD, evaluated abdominal aortic aneurysm surveillance in postoperative settings. […] We compared the standard for postoperative abdominal aortic aneurysm surveillance, maximum aortic diameter, to volumetric analysis of abdominal aortic aneurysm. […] The change of volume was more sensitive compared to diameter change, especially after endovascular abdominal aortic aneurysm repair. […] Our volumetric aneurysm analysis confers that you can detect that and potentially intervene early on. […] Volumetric evaluation has less interobserver variability compared to maximum diameter because diameter can be measured in different planes, oftentimes not orthogonal to the centerline of flow, and that may introduce some false findings in aortic aneurysm behavior. […] We are developing predictive clinical tools for a more sensitive analysis of aneurysm post intervention.

• #55 Updates on AAA screening and surveillance

  https://www1.racgp.org.au/ajgp/2018/may/aaa-screening-and-surveillance

  On the basis of evidence showing substantial benefit, the US Preventive Services Task Force (USPSTF) recommends one-time ultrasonography screening for men aged 65-75 years who have ever smoked. […] The justification for screening programs has been further revisited by the publication of a 2017 meta-analysis of all reported trials, which concluded that screening reduces AAA-related deaths (odds ratio [OR] 0.66, 95% CI: 0.47, 0.93, P 0.02). […] While aortic aneurysm surveillance is generally recommended on the basis of maximal aortic diameter, it is recognised that this is merely a crude surrogate marker for rupture risk. […] Current research explores materials modelling, computational fluid dynamics and finite element analysis in order to predict how aneurysms will grow and the potential location and timing of rupture.

• #56 Recommendations | Abdominal aortic aneurysm: diagnosis and management | Guidance | NICE

  https://www.nice.org.uk/guidance/ng156/chapter/recommendations

  Consider endovascular aneurysm repair (EVAR) or open surgical repair for people with a ruptured infrarenal abdominal aortic aneurysm (AAA). Be aware that: […] Enrol people who have had endovascular aneurysm repair (EVAR) into a surveillance imaging programme. […] Consider open, endovascular or percutaneous intervention for type 1 and type 3 endoleaks following endovascular aneurysm repair (EVAR).

• #57 The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance

  https://www.mdpi.com/2077-0383/13/1/193

  Current ESVS guidelines recommend that patients at a low risk of EVAR failure, based on the first postoperative CTA, may be considered for less-frequent surveillance imaging. […] However, this recommendation considers the maximum diameter alterations and the presence of an endoleak as predictors of a stricter surveillance protocol. […] More data are needed to recognize small-diameter and high-volume AAAs with a high risk of rupture.

• #58 The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance

  https://www.mdpi.com/2077-0383/13/1/193

  Current ESVS guidelines recommend that patients at a low risk of EVAR failure, based on the first postoperative CTA, may be considered for less-frequent surveillance imaging. […] However, this recommendation considers the maximum diameter alterations and the presence of an endoleak as predictors of a stricter surveillance protocol. […] More data are needed to recognize small-diameter and high-volume AAAs with a high risk of rupture.

• #59 Integrated Aortic Program | Thoracic Aneurysm Program

  https://www.valleyhealth.com/services/integrated-aortic-program

  Living with an aortic aneurysm can be stressful, but when managed properly, patients can enjoy an excellent quality of life. […] Our well-established diagnostic, surgical and surveillance program offers comprehensive care for patients with aortic aneurysm. […] A person may be screened for an aneurysm if they have a family history of thoracic aneurysms or connective tissue disease. […] Most patients do not need surgery, and their aneurysm can be safely managed using surveillance and medical follow-up. […] Valley currently has over 1,700 patients under surveillance in the program, ranging from 17 to 90 years of age. […] The First-Degree Relative program provides screening, imaging and long-term surveillance for those individuals who have a relative diagnosed with a thoracic aneurysm.

• #60 Integrated Aortic Program | Thoracic Aneurysm Program

  https://www.valleyhealth.com/services/integrated-aortic-program

  Patients also receive personalized education on safe activities and lifting with an aneurysm. […] For most patients, regular surveillance combined with risk factor management is enough treatment to safely manage their aneurysm. […] Each patient is seen regularly to monitor their aorta. […] We encourage patients and their families to reach out to our nurse practitioners at any time should any questions or concerns arise. […] Valleys Integrated Aortic Program has patient support groups that meet regularly online and in person. […] Through our First Degree Relative program, we also monitor family clusters of aortic aneurysms.

• #61 Aortic aneurysm – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_aneurysm

  According to a review of global data through 2019, the prevalence of abdominal aortic aneurysm worldwide was about 0.9% in people under age 79 years, and is about four times higher in men than in women at any age. Death occurs in about 55-64% of people having rupture of the AAA. […] Screening with ultrasound is indicated in those at high risk. Prevention is by decreasing risk factors, such as smoking, and treatment is either by open or endovascular surgery. Aortic aneurysms resulted in about 152,000 deaths worldwide in 2013, up from 100,000 in 1990. […] Globally, aortic aneurysms resulted in about ~170,000 deaths in 2017. This figure represents an increase from approximately ~100,000 in 1990.

• #62 Abdominal aortic aneurysm surveillance program saving lives

  https://health.ucdavis.edu/news/headlines/abdominal-aortic-aneurysm-surveillance-program-saving-lives/2022/11

  UC Davis Health and AI (artificial intelligence) software company Illuminate have developed a centralized abdominal aortic aneurysm surveillance program that is saving lives. The effort identifies at-risk abdominal aortic aneurysm (AAA) patients who may have been lost-to-follow-up because they missed care during the pandemic or other factors. […] In its first six months, the program has identified over 11,000 patients with some mention of AAA who could benefit from monitoring. […] According to the Society for Vascular Surgery, each year 200,000 people in the United States are diagnosed with an AAA. A ruptured AAA is the 15th leading cause of death in the country and the 10th leading cause of death in men older than 55.

• #63 Abdominal aortic aneurysm epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Abdominal_aortic_aneurysm_epidemiology_and_demographics

  Abdominal aortic aneurysm is the 13th leading cause of death in the US. Abdominal aortic aneurysms are more common in developed countries. Elderly, caucasian males who are smokers are at a higher risk for developing an abdominal aortic aneurysm. […] The incidence of abdominal aortic aneurysms increases after age 60 and peaks in the seventh and eighth decades of life. […] The prevalence among males over 60 years is 2000-6000/100,000. […] Abdominal aortic aneurysms (AAA) is a disease of the elderly, and is the 10th leading cause of death in older men in the United States. […] An individual’s risk of AAA increases by 6% per decade of life. […] Rupture of the AAA occurs in 1-3% of men aged 65 or more with an associated mortality rate of 70-95%. […] AAA tends to cluster in families, therefore affecting younger members of families in the absence of traditional acquired risk factors.

• #64

  https://journals.lww.com/annalsofsurgery/fulltext/2023/06000/the_global_and_regional_prevalence_of_abdominal.9.aspx

  A substantial proportion of people are affected by AAA. There is a need to optimize epidemiological studies to promptly respond to at-risk and identified cases to improve outcomes. […] Epidemiological reports on AAA vary across age, sex, and locations worldwide. […] Most studies have identified advanced age, male sex, ever smoking, high blood pressure, and family history of AAA as the most important risk factors driving the burden of AAA. […] In 2017, the Global Burden of Disease (GBD) collaborators reported that AAA accounted for ~170,000 deaths and 3 million disability-adjusted life years worldwide. […] Despite these figures, the true global burden of AAA remains vague. […] Some authors noted that, despite a seemingly decreasing trend in AAA, prevalence and mortality in settings across Latin America, Asia Pacific, and Africa may be increasing.

• #65

  https://link.springer.com/article/10.1007/s44197-025-00369-y

  Aortic aneurysm has a subtle onset, high rupture mortality, rapid progression in younger individuals, and increasing annual mortality rates. Our study aimed to estimate the global burden and trends of early-onset aortic aneurysm from 1990 to 2021. […] From 1990 to 2021, the ASDR for aortic aneurysm in adolescents and young adults increased from 0.12 (95% confidence interval [CI] 0.11, 0.14) to 0.13 (0.11, 0.14) per 100,000 population, with an AAPC of 0.08% (-0.08%, 0.25%). The ASDALYR rose from 7.25 (6.52, 8.30) to 7.35 (6.51, 8.37), with an AAPC of 0.07% (-0.09%, 0.23%). Both ASDR and ASDALYR are higher in males than females, with a declining trend in females. Higher Socio-Demographic Index (SDI) countries exhibit higher ASDR and ASDALYR compared to lower SDI countries, with a continuous decline observed in high SDI nations.

• #66

  https://link.springer.com/article/10.1007/s44197-025-00369-y

  The overall burden of early-onset aortic aneurysms has exhibited an increasing trend over the last three decades, especially in lower SDI countries. There is an urgent need to develop targeted prevention and control strategies across different regions and countries worldwide. […] The incidence and deaths rates of aortic aneurysm exhibit significant regional variability, with notably higher mortality rates in Tropical Latin America and Eastern Europe compared to other regions. […] Aortic aneurysm rupture represents a vascular emergency. Its incidence and deaths rates are increasing with a tendency of early onset in younger age groups. […] It is anticipated that early-onset aortic aneurysm will emerge as a critical global public health issue over the next two decades. Therefore, it is crucial to monitor and promptly analyze the epidemiological profile of early-onset aortic aneurysms.

• #67 Patients with Abdominal Aortic Aneurysm (AAA) | Society for Vascular Surgery

  https://vascular.org/node/87

  Every year, 200,000 people in the U.S. are diagnosed with an abdominal aortic aneurysm (AAA), a dilation of the main artery within the abdomen. […] A ruptured AAA is the 15th leading cause of death in the country (~4,500 cases/yr) and the 10th leading cause of death in men older than 55. AAAs occur in up to 13 percent of men and 6 percent of women over the age of 65. […] Because the mortality associated with elective aneurysm repair is drastically lower than following repair of a ruptured AAA, the emphasis must be on early detection and repair prior to the occurrence of rupture. […] Death from AAA is preventable with early detection and appropriate, timely treatment. […] Screening for AAA in specific patient populations has been shown to improve disease mortality and can be done without any patient risk using duplex ultrasound.

• #68 Aortic aneurysms Screening, surveillance and referral

  https://www.racgp.org.au/afp/2013/june/aortic-aneurysms

  Aortic aneurysms are a common finding in elderly patients. Rupture of an aortic aneurysm is a catastrophic event associated with a very high mortality. […] Screening of men aged 65 years and over has been shown to reduce aneurysm related mortality, however, no formal screening guidelines exist in Australia. In addition to the risk of aneurysm expansion and rupture, patients are at increased risk of cardiovascular morbidity and mortality. Small aneurysms should be managed with surveillance and cardiovascular risk factor modification. Large aneurysms should be referred promptly to a vascular surgeon for assessment and repair. […] Currently no formal AAA screening guidelines or programs exist in Australia, unlike Sweden, the United Kingdom and the United States. Screening with ultrasound in men over the age of 65 years has been demonstrated to reduce aneurysm related mortality in four large trials, including one performed in Western Australia.

• #69

  https://www.gov.uk/government/publications/aaa-screening-programmes-in-the-uk-10-year-effectiveness-review/uk-aaa-screening-programmes-10-year-effectiveness-review

  The main finding of this review is the steady decline in deaths in men from rAAA during the decade of study. […] The screening programme itself has been shown to be effective. Almost 3.5 million men have been invited for screening, with an uptake of around 80% – higher than almost all the adult national screening programmes. […] The question is, how much of the reduction in death from rAAA is due to screening and how much is due to changes in disease prevalence and other improvements in healthcare? […] The best evidence comes from the NVR, where the reduction in the number of rAAA was by approximately two thirds in the screened cohort and only a half in the non-screened cohort. […] NHS AAA screening programmes are effective at identifying men with AAA and referring men for treatment. […] NHS AAA screening programmes remain cost effective at NICE willingness to pay thresholds, despite falling prevalence in 65-year-old men.

• #70 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  Important risk factors for AAA include older age, male sex, smoking, and having a first-degree relative with an AAA. […] Epidemiologic literature commonly defines an ever smoker as someone who has smoked 100 or more cigarettes. […] Indirect evidence shows that smoking is the strongest predictor of AAA prevalence, growth, and rupture rates. […] Family history of AAA in a first-degree relative doubles the risk of developing AAA. […] The primary method of screening for AAA is conventional abdominal duplex ultrasonography. […] Evidence is adequate to support 1-time screening for men who have ever smoked. […] The majority of screen-detected AAAs (90%) are between 3.0 and 5.5 cm in diameter and thus below the usual threshold for surgery. […] The current standard of care for patients with stable smaller aneurysms is to maintain ultrasound surveillance at regular intervals because the risk of rupture is small.

• #71 Surveillance of moderate-size aneurysms of the thoracic aorta | Journal of Cardiothoracic Surgery | Full Text

  https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-015-0220-2

  There are no evidence based guidelines for the surveillance of patients with moderate-sized (5 cm) thoracic aortic aneurysms (MTAA), who do not warrant surgical intervention. […] The appropriate frequency and mode of surveillance are unclear. […] Current management is guided by best clinical judgment. There is no data to guide surveillance of these patients. […] Given the very low aneurysm growth rate of our MTAA patients during the follow-up period, such annual imaging of all patients may be excessive and unnecessary for lower-risk MTAA patient sub-groups as well as pose a potential health hazard related to excessive radiation exposure. […] A data driven patient care plan will guide an optimal surveillance strategy for these patients and spare many the risk and exposure of unnecessary CT imaging.

• #72 About Aortic Aneurysm | Heart Disease | CDC

  https://www.cdc.gov/heart-disease/about/aortic-aneurysm.html

  Aortic aneurysms or aortic dissections were the cause of 9,904 deaths in 2019.1 […] In 2019, about 59% of deaths due to aortic aneurysm or aortic dissection happen among men.1 […] A history of smoking accounts for about 75% of all abdominal aortic aneurysms.2 […] The US Preventive Services Task Force recommends that men aged 65 to 75 years old who have ever smoked should get an ultrasound screening for abdominal aortic aneurysms, even if they have no symptoms.3 […] Abdominal aortic aneurysms are more common in men and among people age 65 and older. Abdominal aortic aneurysms are more common among White people than among Black people.5 […] Diseases and unhealthy behaviors that damage your heart and blood vessels also increase your risk for aortic aneurysm. Smoking is the most important behavior related to aortic aneurysm.

• #73

  https://link.springer.com/article/10.1007/s44197-025-00369-y

  Current epidemiological data on aortic aneurysms, particularly early-onset aortic aneurysm, is extremely limited. […] The Global Burden of Disease (GBD) 2021 database, developed by the Institute for Health Metrics and Evaluation (IHME), represents the most recent version of the comprehensive global health assessment system. This database provides a valuable resource for estimating early-onset aortic aneurysm at global, national, and regional levels. Current study presents the latest global epidemiological characteristics of early-onset aortic aneurysms (i.e., aortic aneurysm in adolescents and young adults aged 15-39 years), analyzes its temporal and spatial trends, and utilizes the Nordpred model to project the disease burden for the year 2045. […] In 2021, the ASDR and ASDALYR were 0.13 (95% confidence interval 0.11, 0.14) and 7.35 (6.51, 8.37) per 100,000 population, respectively.

• #74 Use of linked registry claims data for long term surveillance of devices after endovascular abdominal aortic aneurysm repair: observational surveillance study | The BMJ

  https://www.bmj.com/content/379/bmj-2022-071452

  Objective To evaluate long term outcomes (reintervention and late rupture of abdominal aortic aneurysm) of aortic endografts in real world practice using linked registry claims data. […] The linked registry claims surveillance data identified a device specific risk in long term reintervention after EVAR of abdominal aortic aneurysm. Device manufacturers and regulators can leverage linked data sources to actively monitor long term outcomes in real world practice after cardiovascular interventions. […] At present, no systematic surveillance structure exists to evaluate long term outcomes of aortic endografts in real world practice. […] The surveillance sensitivity analysis indicated that between three and five years had elapsed before the risk of reintervention became evident using linked registry claims data. Based on conventional reporting mechanisms, the FDA issued its first written communication warnings based on reports from the manufacturer in 2017, more than two years after the signal was evident in our surveillance analyses based on linked registry claims data.

• #75 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  The extent of overdiagnosis and overtreatment is difficult to estimate. […] Studies examining the efficacy of screening and treatment in diverse populations (eg, older adults, women, and racial/ethnic groups) are needed to inform the need for specific recommendations in subpopulations of Americans.

• #76 The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance

  https://www.mdpi.com/2077-0383/13/1/193

  There has been a debate about whether maximum diameter can be solely used to assess the natural history of abdominal aortic aneurysm. […] The current literature appears to reinforce the role of volume as a supplementary measure for evaluating the natural history of AAA, in both intact AAAs and after EVAR. […] The clinical impact of AAA volume measurements remains unclear. Several studies show that volumetric analysis can assess changes in AAAs and predict successful endoluminal exclusion after EVAR more accurately than diameter. […] The monitoring of AAAs is mostly targeted to the sequential measurement of maximum abdominal aortic aneurysm diameter. […] Measuring aneurysm volume has also been proposed to possibly add to AAA assessment and improve growth prediction and help in treatment strategies.

• #77 Postoperative Abdominal Aortic Aneurysm (AAA) Surveillance < Yale School of Medicine

  https://medicine.yale.edu/news-article/publication-and-the-pi-postoperative-abdominal-aortic-aneurysm-surveillance/

  Yale Department of Surgerys Edouard Aboian, MD, evaluated abdominal aortic aneurysm surveillance in postoperative settings. […] We compared the standard for postoperative abdominal aortic aneurysm surveillance, maximum aortic diameter, to volumetric analysis of abdominal aortic aneurysm. […] The change of volume was more sensitive compared to diameter change, especially after endovascular abdominal aortic aneurysm repair. […] Our volumetric aneurysm analysis confers that you can detect that and potentially intervene early on. […] Volumetric evaluation has less interobserver variability compared to maximum diameter because diameter can be measured in different planes, oftentimes not orthogonal to the centerline of flow, and that may introduce some false findings in aortic aneurysm behavior. […] We are developing predictive clinical tools for a more sensitive analysis of aneurysm post intervention.

• #78 Use of linked registry claims data for long term surveillance of devices after endovascular abdominal aortic aneurysm repair: observational surveillance study | The BMJ

  https://www.bmj.com/content/379/bmj-2022-071452

  Long term reintervention and rupture after EVAR varies by device manufacturer, and failures are common, especially for early generation devices. More broadly, for patients facing invasive cardiovascular procedures, distributed research networks incorporating hybrid claims based registry data sources offer an efficient pathway for systematic surveillance of long term outcomes in real world practice.

• #79 The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance

  https://www.mdpi.com/2077-0383/13/1/193

  Current ESVS guidelines recommend that patients at a low risk of EVAR failure, based on the first postoperative CTA, may be considered for less-frequent surveillance imaging. […] However, this recommendation considers the maximum diameter alterations and the presence of an endoleak as predictors of a stricter surveillance protocol. […] More data are needed to recognize small-diameter and high-volume AAAs with a high risk of rupture.

• #80 Recommendation: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening

  The extent of overdiagnosis and overtreatment is difficult to estimate. […] Studies examining the efficacy of screening and treatment in diverse populations (eg, older adults, women, and racial/ethnic groups) are needed to inform the need for specific recommendations in subpopulations of Americans.

• #81

  https://link.springer.com/article/10.1007/s44197-025-00369-y

  The global ASDR increased from 0.12 (95% confidence interval 0.11, 0.14) in 1990 to 0.13 (0.11, 0.14) in 2021. […] The ASDR and ASDALYR for early-onset aortic aneurysm can be attributed to seven risk factors, categorized into four main groups: tobacco risks (smoking), dietary risks (low vegetable intake, low fruit intake, and high sodium intake), metabolic risks (high systolic blood pressure and high body-mass index), and environmental risks (lead exposure). Overall, smoking is the primary attributable risk factor for aortic aneurysm across all regions, time periods, and genders. […] The proportion of early-onset aortic aneurysm deaths attributable to smoking globally decreased from 41 to 39%. […] The burden of early-onset aortic aneurysm will continue to rise in the next 20 years, particularly in Asian and African regions. It is necessary to strengthen vascular health prevention strategies and aortic aneurysm management in these regions.

• #82 Treatment in Thoracic Aortic Aneurysm: Surgery vs Surveillance | Mount Sinai – New York

  https://www.mountsinai.org/clinical-trials/treatment-in-thoracic-aortic-aneurysm-surgery-vs-surveillance

  The ascending aorta can become enlarged, and the risk of tearing and rupturing becomes higher with larger aorta. […] In the TITAN SvS trial, patients with an ascending aorta between 5.0 to 5.5 cm is assigned by chance to the early surgery group, in which they will undergo replacement of aorta, or the surveillance group, in which they will be closely monitored. […] This is a prospective, multi-centre randomized control trial that compares the all-cause mortality, aneurysm-related aortic events, rate of stroke, and quality of life for those patients undergoing early elective ascending aortic surgery to those patients undergoing surveillance. […] The primary objective of the trial is to compare the composite outcome of the all-cause mortality and incidence of acute aortic events between surveillance and elective ascending aortic surgery for patients with degenerative or bicuspid valve-related ascending aortic aneurysm after 2 years of follow up. […] The result of this trial will provide evidence based guidance in the appropriate management of ascending aortic aneurysm based on the size criteria, and establish a large database for future investigations.

• #83 UCSF Aneurysm Trial → Treatment in Thoracic Aortic Aneurysm: Surgery vs Surveillance

  https://clinicaltrials.ucsf.edu/trial/NCT03536312

  The TITAN SvS trial compares the chance of dying or suffering tearing or rupture of the aorta between patients with an ascending aorta between 5.0 to 5.5 cm assigned to early surgery or surveillance. […] The primary objective of the trial is to compare the composite outcome of the all-cause mortality and incidence of acute aortic events between surveillance and elective ascending aortic surgery for patients with degenerative or bicuspid valve-related ascending aortic aneurysm after 2 years of follow up. […] The result of this trial will provide evidence based guidance in the appropriate management of ascending aortic aneurysm based on the size criteria, and establish a large database for future investigations. […] Patients with ascending aortic aneurysm with a diameter of 4.5 cm – 4.9 cm will be observed with serial CT, and will be considered for enrollment into the trial once the aneurysm reaches 5.0 cm.

• #84 Thoracic aortic aneurysm: Optimal surveillance and treatment | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/557

  Aneurysm of the thoracic aorta is less common than in the abdominal aorta, but it is clinically important because of the risk of rupture and death. […] Surveillance with various imaging tests is critical before and after intervention to guide treatment. […] Guidelines from several professional societies are available regarding surveillance and indications for intervention. […] Regular imaging surveillance is critical after diagnosis and after aneurysm interventions. […] There are no effective preventive strategies for TAA to date; thus, early detection, surveillance, and treatment are critical to improving outcomes. Guidelines are available. […] Most cases of TAA are asymptomatic and are discovered either incidentally on imaging or as part of dedicated screening for those at risk.

• #85 Aortic aneurysms Screening, surveillance and referral

  https://www.racgp.org.au/afp/2013/june/aortic-aneurysms

  Aortic aneurysms are a common finding in elderly patients. Rupture of an aortic aneurysm is a catastrophic event associated with a very high mortality. […] Screening of men aged 65 years and over has been shown to reduce aneurysm related mortality, however, no formal screening guidelines exist in Australia. In addition to the risk of aneurysm expansion and rupture, patients are at increased risk of cardiovascular morbidity and mortality. Small aneurysms should be managed with surveillance and cardiovascular risk factor modification. Large aneurysms should be referred promptly to a vascular surgeon for assessment and repair. […] Currently no formal AAA screening guidelines or programs exist in Australia, unlike Sweden, the United Kingdom and the United States. Screening with ultrasound in men over the age of 65 years has been demonstrated to reduce aneurysm related mortality in four large trials, including one performed in Western Australia.

• #86 Updates on AAA screening and surveillance

  https://www1.racgp.org.au/ajgp/2018/may/aaa-screening-and-surveillance

  On the basis of evidence showing substantial benefit, the US Preventive Services Task Force (USPSTF) recommends one-time ultrasonography screening for men aged 65-75 years who have ever smoked. […] The justification for screening programs has been further revisited by the publication of a 2017 meta-analysis of all reported trials, which concluded that screening reduces AAA-related deaths (odds ratio [OR] 0.66, 95% CI: 0.47, 0.93, P 0.02). […] While aortic aneurysm surveillance is generally recommended on the basis of maximal aortic diameter, it is recognised that this is merely a crude surrogate marker for rupture risk. […] Current research explores materials modelling, computational fluid dynamics and finite element analysis in order to predict how aneurysms will grow and the potential location and timing of rupture.

• #87 Postoperative Abdominal Aortic Aneurysm (AAA) Surveillance < Yale School of Medicine

  https://medicine.yale.edu/news-article/publication-and-the-pi-postoperative-abdominal-aortic-aneurysm-surveillance/

  Yale Department of Surgerys Edouard Aboian, MD, evaluated abdominal aortic aneurysm surveillance in postoperative settings. […] We compared the standard for postoperative abdominal aortic aneurysm surveillance, maximum aortic diameter, to volumetric analysis of abdominal aortic aneurysm. […] The change of volume was more sensitive compared to diameter change, especially after endovascular abdominal aortic aneurysm repair. […] Our volumetric aneurysm analysis confers that you can detect that and potentially intervene early on. […] Volumetric evaluation has less interobserver variability compared to maximum diameter because diameter can be measured in different planes, oftentimes not orthogonal to the centerline of flow, and that may introduce some false findings in aortic aneurysm behavior. […] We are developing predictive clinical tools for a more sensitive analysis of aneurysm post intervention.

• #88

  https://journals.lww.com/annalsofsurgery/fulltext/2023/06000/the_global_and_regional_prevalence_of_abdominal.9.aspx

  In 2019, WPR had the largest number of AAA cases, whereas AFR had the least. […] Similarly, the prevalence of AAA was the highest in the WPR, but the lowest in the AFR. […] Importantly, the relatively large number of AAA cases in AFR and EMR in the young-age to middle-age groups makes the 2 regions an important target for response. […] We also reaffirm the importance of smoking, male sex, and family history as leading risks of AAA globally, with the WPR the most affected region globally. […] We note a need to optimize epidemiological studies and existing structures for research in LMICs and resource-limited populations to promptly respond to at-risk and identified cases to improve outcomes.

• #89

  https://link.springer.com/article/10.1007/s44197-025-00369-y

  The global ASDR increased from 0.12 (95% confidence interval 0.11, 0.14) in 1990 to 0.13 (0.11, 0.14) in 2021. […] The ASDR and ASDALYR for early-onset aortic aneurysm can be attributed to seven risk factors, categorized into four main groups: tobacco risks (smoking), dietary risks (low vegetable intake, low fruit intake, and high sodium intake), metabolic risks (high systolic blood pressure and high body-mass index), and environmental risks (lead exposure). Overall, smoking is the primary attributable risk factor for aortic aneurysm across all regions, time periods, and genders. […] The proportion of early-onset aortic aneurysm deaths attributable to smoking globally decreased from 41 to 39%. […] The burden of early-onset aortic aneurysm will continue to rise in the next 20 years, particularly in Asian and African regions. It is necessary to strengthen vascular health prevention strategies and aortic aneurysm management in these regions.

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