Abdominal aortic aneurysms ultrasound screening of rural Israeli Arab smokers

Chirurgia ◽  
2020 ◽  
Vol 33 (1) ◽  
Author(s):  
Asaf Rabin ◽  
Rana Afifi ◽  
Liana Fahoum ◽  
Sigalit Rappaport ◽  
Ron Karmeli
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Ultrasound Screening ◽  
Abdominal Aortic

Screening Program of Abdominal Aortic Aneurysm

Angiology ◽  
2019 ◽  
Vol 70 (5) ◽  
pp. 407-413 ◽  
Author(s):  
Muriel Sprynger ◽  
Michel Willems ◽  
Hendrik Van Damme ◽  
Benny Drieghe ◽  
J. C. Wautrecht ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Screening Program ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Ultrasound Screening ◽  
Care Providers ◽  
Abdominal Ultrasonography ◽  
Screening Programs ◽  
Abdominal Aortic ◽  
Elective Repair

In Europe, the prevalence of abdominal aortic aneurysms (AAAs) in the elderly population (≥65 year old) has declined in the past decades to <4%. Aneurysmal degeneration of the aorta is a serious and potentially life-threatening vascular disease. Abdominal aortic aneurysms typically develop subclinically and often only become symptomatic when complicated by impending rupture. Most AAAs are discovered incidentally while investigating for an unrelated pathology. Ruptured AAA is the tenth leading cause of death in Belgium (0.32% of all deaths in 2014). Health-care providers have emphasized the importance of early detection of AAA and elective repair when the rupture risk outweighs operative risk (usual diameter threshold of 55 mm). Routine AAA screening programs, consisting of a single abdominal ultrasonography at the age of 65 years, aim to reduce the number of AAA-related deaths. Does population-based ultrasound screening for AAA achieve its objective and is it cost-effective? This literature review tries to answer these challenging questions.

Is Screening Once at Age 65 an Effective Method for Detection of Abdominal Aortic Aneurysms?

1994 ◽  
Vol 1 (4) ◽  
pp. 223-225 ◽  
Author(s):  
D E Khoo ◽  
H Ashton ◽  
R A P Scott
Keyword(s):  
Operative Mortality ◽  
District General Hospital ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Ultrasound Screening ◽  
Men And Women ◽  
Hospital District ◽  
Age Related ◽  
Abdominal Aortic ◽  
Acceptance Rates

To evaluate whether a single screening at 65 or screening at 65 and 70 are the methods of choice to detect the majority of abdominal aortic aneurysms (AAA) suitable for treatment. District general hospital, district general practice and community. Data were collated from four studies (a pilot, a control trial, and two cohorts) of abdominal ultrasound screening of an invited group of 11 666 men and women aged 65–80 to derive age related prevalence, invitation acceptance rates, and operative mortality. Deaths from AAA rupture were obtained from district registrars' returns. The prevalence of AAA increased with age being greater overall in men (6·8%) than in women (1·2%). From ages 65 to 80 the prevalence in men increased from 5·4% to 10·4%, and in women from 0·6% to 2·1%. In men and women 4% of patients dying from AAA rupture were aged 65 or under and 85% of deaths occurred over the age of 70. Acceptance rates for screening decreased between 65 and 80 from 80·5% to 66·2% in men and from 72·7% to 58·3% in women. In elective or symptomatic patients operative mortality was zero up to the age of 70, increasing to 7·1% in older patients. Men should be screened at age 65 to obtain a high acceptance rate and to identify those with AAA most likely to benefit from treatment. The prevalence is relatively low at this age so an additional screen at age 70 is recommended, which would pick up a further 3·7% of patients with AAA, at which age intervention is likely to be of benefit.

scholarly journals Low Progesterone and Low Estradiol Levels Associate with Abdominal Aortic Aneurysms in Men

2021 ◽  
Author(s):  
Claes Ohlsson ◽  
Marcus Langenskiöld ◽  
Kristian Smidfelt ◽  
Matti Poutanen ◽  
Henrik Ryberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Abdominal Aortic Aneurysms ◽  
Reproductive Hormones ◽  
Sex Hormone ◽  
Aortic Aneurysms ◽  
Infrarenal Aorta ◽  
Ultrasound Screening ◽  
Early Screening ◽  
Abdominal Aortic

Abstract Context Male sex is a major risk factor for abdominal aortic aneurysms (AAA) but few studies have addressed associations between sex hormone levels and AAA. Objective To describe the associations between serum sex steroids and early, screening-detected AAA in men. Design, Setting and Participants We validated a high-sensitivity liquid chromatography-tandem mass spectrometry assay for comprehensive serum sex hormone profiling. This assay was then employed in a case-control study including 147 men with AAA (infrarenal aorta ≥30 mm) and 251 AAA-free controls recruited at the general population-based ultrasound screening for AAA in 65-year-old Swedish men. Main Outcome Measures Associations between dehydroepiandrosterone, progesterone, 17α-hydroxyprogesterone, androstenedione, estrone, testosterone, dihydrotestosterone, and estradiol and AAA presence. Results Dehydroepiandrosterone, progesterone, 17α-hydroxyprogesterone, testosterone, and estradiol, but not the other hormones, were lower in men with AAA. In models with adjustments for known AAA risk factors and comorbidity, only progesterone (odds ratio per SD decrease 1.62 [95% CI 1.18-2.22]) and estradiol (1.40 [95% CI 1.04-1.87]) remained inversely associated with the presence of AAA. Progesterone and estradiol contributed with independent additive information for prediction of AAA presence; compared with men with high (above median) levels, men with low (below median) levels of both hormones had a 4-fold increased odds ratio for AAA (4.06 [95% CI 2.25-7.31]). Conclusions Measured by a high-performance sex steroid assay, progesterone and estradiol are inversely associated with AAA in men, independently of known risk factors. Future studies should explore whether progesterone and estradiol, which are important reproductive hormones in women, are protective in human AAA.

Screening cardiovascular patients for aortic aneurysms (SCAN) – high prevalence of abdominal aortic aneurysms in coronary heart disease patients requiring intervention

VASA ◽  
2020 ◽  
Vol 49 (5) ◽  
pp. 375-381
Author(s):  
Benedikt Reutersberg ◽  
Michael Salvermoser ◽  
Bernhard Haller ◽  
Christoph Schäffer ◽  
Eva Knipfer ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Abdominal Aortic Aneurysms ◽  
Coronary Intervention ◽  
Aortic Aneurysms ◽  
Ultrasound Screening ◽  
Screening Programs ◽  
Abdominal Aortic ◽  
Cardiovascular Patients ◽  
Male Patients

Summary: Background: Since the prevalence of abdominal aortic aneurysms (AAA) in Europe has declined to about 2.5%, general screening programs of elderly men are being called into question. On the other hand, other vascular diseases (e.g. coronary heart disease, CHD) are associated with a higher prevalence of AAA. This might have an impact on future targeted AAA screening programs. This study aimed to reevaluate the current prevalence of AAA in male patients with CHD, in order to assess whether CHD patients should be offered a targeted AAA ultrasound screening program. Patients and methods: The SCAN (Screening Cardiovascular Patients for Aortic Aneurysms) study prospectively evaluated the AAA prevalence in 1000 consecutive male CHD patients (70.1 ± 11.2 years) requiring any coronary intervention at an university hospital. All patients received transverse and longitudinal ultrasound scans of the abdominal aorta. Aortic diameter was assessed using the outer-to-outer measurement-technique. Primary endpoint was the prevalence of AAA. Secondary outcomes included stratification in 1-, 2-, or 3-vessel CHD. Results: AAA was detected in 85 patients (median diameter 38 mm, range 30–80 mm), corresponding to an overall prevalence of 8.5%. AAA prevalence was significantly associated with CHD severity: 5.6% in 1-vessel, 7.1% in 2-vessel, and 10.8% in 3-vessel CHD (P = 0.037). The multivariable analysis showed, that age per 10 years increase (OR 1.5, 95% CI 1.2–1.9, P = 0.001) and hyperlipidemia (OR 2.2, 95% CI 1.3–3.8, P = 0.003) were significantly associated with an AAA. The likelihood to be diagnosed with an AAA was significantly lower in non-smokers (OR 0.24, 95% CI, P < 0.001). Conclusions: This study confirms that CHD requiring any type of coronary intervention is strongly associated with AAA in male patients. AAA prevalence increases with CHD severity. Since the AAA prevalence is still significantly higher than in the general population, targeted ultrasound screening should be considered for all CHD patients.

Ultrasound screening for abdominal aortic aneurysms

2015 ◽  
Vol 20 (S1) ◽  
pp. 1-12 ◽  
Author(s):  
H.-H. Eckstein ◽  
C. Reeps ◽  
A. Zimmermann ◽  
H. Söllner
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Ultrasound Screening ◽  
Abdominal Aortic

scholarly journals Prospective Ultrasound Screening of Men with Cerebrovascular Disease for Abdominal Aortic Aneurysms

2020 ◽  
pp. 145749692091726
Author(s):  
V. Vänni ◽  
J. Turtiainen ◽  
U. Kaustio ◽  
J. Toivanen ◽  
M. Rusanen ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Cerebrovascular Disease ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Maximum Diameter ◽  
Infrarenal Aorta ◽  
Ultrasound Screening ◽  
Abdominal Aortic ◽  
Male Patients

Background: The prevalence of abdominal aortic aneurysms is higher in population with other vascular comorbidities, especially among men. Utility of screening among patients with cerebrovascular disease is unclear. Objective: To determine the prevalence of abdominal aortic aneurysm in male patients with diagnosed cerebrovascular disease manifested by transient ischemic attack or stroke. Material and Methods: Between May 2013 and May 2014, all consecutive male patients undergoing carotid ultrasound in single tertiary center with a catchment area of 179,000 inhabitants were evaluated for ultrasound screening of abdominal aortic aneurysm. Abdominal aortic aneurysm was defined as maximum diameter of infrarenal aorta 30 mm or more. Results: Of 105 (n = 105) consecutively evaluated male patients, only 69% (n = 72) were eligible for the study and underwent aortic screening. Reason for ineligibility was most often poor general medical condition (n = 29). Mean age of screened patients was 66 years (SD 9.8 years). Half of the screened patients suffered stroke (n = 36). The incidence of abdominal aortic aneurysm was 5.6% (n = 4). All found abdominal aortic aneurysms were small and did not require immediate surgical intervention. During a follow-up period of over 4 years, none of the aneurysms exhibited tendency for growth. Conclusion: The male population with cerebrovascular disease is comorbid and frail. Only, moderate prevalence of abdominal aortic aneurysms can be found in this subpopulation.

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