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Five Year Natural History of Screening Detected Sub-Aneurysms and Abdominal Aortic Aneurysms in 70 Year Old Women and Systematic Review of Repair Rate in Women
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Falun Cty Hosp, Dept Surg, Falun, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Falun Cty Hosp, Dept Surg, Falun, Sweden..ORCID iD: 0000-0002-5616-8393
2017 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 53, no 6, 802-809 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to report on the natural history of a population based cohort of 70 year old women with screening detected dilated aortas, and to systematically review publications reporting the rate of intact infrarenal aneurysm repair in women.

Material and methods: In a previous study, 5140 (74%) of 6925 invited women attended an ultrasound (US) examination of the abdominal aorta at age 70 years. All 52 women with screening detected sub-aneurysms (SA, diameter 25-29 mm) and abdominal aortic aneurysms (AAA, diameter >= 30 mm), were followed for 5 years with US. Infrarenal aortic diameters, AAA repair, all-cause and AAA specific mortality, and risk factors were recorded. In addition, a systematic review was conducted of the rate of intact infrarenal aneurysm repair in women.

Results: A total of 33 (0.6%) women had a SA at the age of 70; two (6%) declined follow-up, five (15%) had died, and 26 were re-examined after 5 years follow-up at age 75. Twelve of 26 (46%) had progressed to AAAs, where one was directly qualified for surgery. Smoking (p = .010) and aortic diameter (p = .040) were associated with progression to AAA. A total of 19 (0.4%) women had an AAA at age 70; two (11%) had died, six (32%) had been electively repaired with no 30 day mortality, and 11 (58%) had an AAA still under surveillance after 5 years follow-up at age 75 years. In the systematic search four studies with heterogeneous cohorts were identified and data on natural history were extracted and reviewed.

Conclusion: Screening detected AAAs and sub-aneurysms are clinically relevant in women. Within 5 years of detection a high proportion of AAAs require elective surgery, and a high proportion of sub-aneurysms progress to AAAs. Consequently, surveillance of sub-aneurysms in women with reasonable life expectancy can be considered. Publications on repair rate in women with intact AAAs are scarce and heterogeneous.

Place, publisher, year, edition, pages
2017. Vol. 53, no 6, 802-809 p.
Keyword [en]
Abdominal aortic aneurysm, Women, Mass screening, Smoking, Ultrasonography
National Category
Cardiac and Cardiovascular Systems Surgery
Identifiers
URN: urn:nbn:se:uu:diva-329711DOI: 10.1016/j.ejvs.2017.02.024ISI: 000403518800009PubMedID: 28389251OAI: oai:DiVA.org:uu-329711DiVA: diva2:1146538
Available from: 2017-10-03 Created: 2017-10-03 Last updated: 2017-10-03Bibliographically approved

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Söderberg, PatrikWanhainen, AndersSvensjö, Sverker

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