TY - JOUR
T1 - Role of volume in small abdominal aortic aneurysm surveillance
AU - Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial Investigators
AU - Olson, Sydney L.
AU - Panthofer, Annalise M.
AU - Blackwelder, William
AU - Terrin, Michael L.
AU - Curci, John A.
AU - Baxter, B. Timothy
AU - Weaver, Fred A.
AU - Matsumura, Jon S.
N1 - Funding Information:
The authors thank Jennifer Grudzinski, BS, RT(R)(M) (University of Wisconsin School of Medicine and Public Health), for completing the rigorous measurements that made this project possible. This work was supported by grants R34 AG028684, R01 AG037120, T32 AG000262, and P30 AG0288747 from the National Institute on Aging. N-TA3CT was funded by the National Institutes of Health (NIH) through a grant award to the University of Maryland, Baltimore. The funding source had no role in the design and conduct of the clinical trial, collection, management, or analysis of the data or interpretation of the results. The NIH appointed an independent Data and Safety Monitoring Board. Neither the NIH nor the Data and Safety Monitoring Board had any role in the preparation, review, or approval of this manuscript or the decision to submit it for publication. Author conflict of interest: M.T. reports grants from the National Institutes of Health (NIH). J.C. reports receiving grants from the NIH. T.B. reports grants from the National Institute on Aging (NIA-NIH). J.M. reports grants from the NIH, Abbott, Cook, Endologix, Gore, and Medtronic. The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a conflict of interest.
Funding Information:
Author conflict of interest: M.T. reports grants from the National Institutes of Health (NIH). J.C. reports receiving grants from the NIH. T.B. reports grants from the National Institute on Aging (NIA-NIH). J.M. reports grants from the NIH, Abbott, Cook, Endologix, Gore, and Medtronic.
Funding Information:
This work was supported by grants R34 AG028684, R01 AG037120, T32 AG000262, and P30 AG0288747 from the National Institute on Aging. N-TA 3 CT was funded by the National Institutes of Health (NIH) through a grant award to the University of Maryland, Baltimore. The funding source had no role in the design and conduct of the clinical trial, collection, management, or analysis of the data or interpretation of the results. The NIH appointed an independent Data and Safety Monitoring Board. Neither the NIH nor the Data and Safety Monitoring Board had any role in the preparation, review, or approval of this manuscript or the decision to submit it for publication.
Publisher Copyright:
© 2021 Society for Vascular Surgery
PY - 2022/4
Y1 - 2022/4
N2 - Objective: Current management of small abdominal aortic aneurysms (AAAs) primarily involves serial imaging surveillance of maximum transverse diameter (MTD) to estimate rupture risk. Other measurements, such as volume and tortuosity, are less well-studied and may help characterize and predict AAA progression. This study evaluated predictors of AAA volume growth and discusses the role of volume in clinical practice. Methods: Subjects from the Non-invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (baseline AAA MTD, 3.5-5.0 cm) with ≥2 computed tomography scans were included in this study (n = 250). Computed tomography scans were conducted approximately every 6 months over 2 years. MTD, volume, and tortuosity were used to model growth. Univariable and multivariable backwards elimination least squares regressions assessed associations with volume growth. Results: Baseline MTD accounted for 43% of baseline volume variance (P < .0001). Mean volume growth rate was 10.4 cm3/year (standard deviation, 8.8 cm3/year) (mean volume change +10.4%). Baseline volume accounted for 30% of volume growth variance; MTD accounted for 13% of volume growth variance. More tortuous aneurysms at baseline had significantly larger volume growth rates (difference, 32.8 cm3/year; P < .0001). Univariable analysis identified angiotensin II receptor blocker use (difference, −3.4 cm3/year; P = .02) and history of diabetes mellitus (difference, −2.8 cm3/year; P = .04) to be associated with lower rates of volume growth. Baseline volume, tortuosity index, current tobacco use, and absence of diabetes mellitus remained significantly associated with volume growth in multivariable analysis. AAAs that reached the MTD threshold for repair had a wide range of volumes: 102 cm3 to 142 cm3 in female patients (n = 5) and 105 cm3 to 229 cm3 in male patients (n = 20). Conclusions: Baseline AAA volume and MTD were found to be moderately correlated. On average, AAA volume grows about 10% annually. Baseline volume, tortuosity, MTD, current tobacco use, angiotensin II receptor blocker use, and history of diabetes mellitus were predictive of volume growth over time.
AB - Objective: Current management of small abdominal aortic aneurysms (AAAs) primarily involves serial imaging surveillance of maximum transverse diameter (MTD) to estimate rupture risk. Other measurements, such as volume and tortuosity, are less well-studied and may help characterize and predict AAA progression. This study evaluated predictors of AAA volume growth and discusses the role of volume in clinical practice. Methods: Subjects from the Non-invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (baseline AAA MTD, 3.5-5.0 cm) with ≥2 computed tomography scans were included in this study (n = 250). Computed tomography scans were conducted approximately every 6 months over 2 years. MTD, volume, and tortuosity were used to model growth. Univariable and multivariable backwards elimination least squares regressions assessed associations with volume growth. Results: Baseline MTD accounted for 43% of baseline volume variance (P < .0001). Mean volume growth rate was 10.4 cm3/year (standard deviation, 8.8 cm3/year) (mean volume change +10.4%). Baseline volume accounted for 30% of volume growth variance; MTD accounted for 13% of volume growth variance. More tortuous aneurysms at baseline had significantly larger volume growth rates (difference, 32.8 cm3/year; P < .0001). Univariable analysis identified angiotensin II receptor blocker use (difference, −3.4 cm3/year; P = .02) and history of diabetes mellitus (difference, −2.8 cm3/year; P = .04) to be associated with lower rates of volume growth. Baseline volume, tortuosity index, current tobacco use, and absence of diabetes mellitus remained significantly associated with volume growth in multivariable analysis. AAAs that reached the MTD threshold for repair had a wide range of volumes: 102 cm3 to 142 cm3 in female patients (n = 5) and 105 cm3 to 229 cm3 in male patients (n = 20). Conclusions: Baseline AAA volume and MTD were found to be moderately correlated. On average, AAA volume grows about 10% annually. Baseline volume, tortuosity, MTD, current tobacco use, angiotensin II receptor blocker use, and history of diabetes mellitus were predictive of volume growth over time.
KW - Abdominal aortic aneurysm
KW - Aneurysm growth
KW - Aneurysm volume
KW - CT surveillance
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U2 - 10.1016/j.jvs.2021.09.046
DO - 10.1016/j.jvs.2021.09.046
M3 - Article
C2 - 34655683
AN - SCOPUS:85118824963
VL - 75
SP - 1260-1267.e3
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
SN - 0741-5214
IS - 4
ER -