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International Angiology 2001 March;20(1):74-7


lingua: Inglese

The characteristics of screened patients with abdominal aortic aneurysm

Ishikawa S., Ohtaki A., Takahashi T., Sakata K., Otani Y., Hamada Y., Koyano T., Kano M., Oshima K., Morishita Y.

From the 2nd Department of Surgery, Gunma University Faculty of Medicine, Gunma, Japan


Background. Screening for abdom­i­nal aor­tic aneu­rysm (AAA) has not yet been estab­lished in Japan. We there­fore ­report the char­ac­ter­is­tics of a ­screened pop­u­la­tion and dis­cuss the impli­ca­tions of screen­ing using ultra­sound in Japan.
Methods. The sub­jects in our screen­ing group were com­posed of 4428 par­tic­i­pants who were 60 years of age or older. Aneurysm was detect­ed in 16 cases, 15 males and 1 ­female, the detec­tion rate being 0.4% in total and 0.9% in the males. We com­pare the char­ac­ter­is­tics of ­screened ­patients (n=16) with non-­screened ­patients oper­at­ed on for abdom­i­nal aor­tic aneu­rysm (n=166).
Results. There were no sig­nif­i­cant dif­fer­enc­es in the mean age or in the ­female ratio between the ­screened and non-­screened ­groups (71 vs 70 y/o, 6% vs 13%, respec­tive­ly). Solitary iliac aneu­rysms were sig­nif­i­cant­ly (p<0.05) more fre­quent in the ­screened than in the non-­screened group (19% vs 3%). The size of aneu­rysm in the ­screened group was sig­nif­i­cant­ly (p<0.05) small­er com­pared with the non-­screened group. Sixty-three per cent of the ­screened group and only 8% of the non-­screened group had an aneu­rysm less than 40 mm in size. Aneurysm was pal­pa­ble in only 31% of those of the ­screened group. There were no sig­nif­i­cant dif­fer­enc­es ­between the ­groups in the fre­quen­cy of arte­rio­scle­rot­ic risk fac­tors such as hyper­ten­sion, ischaem­ic heart dis­ease, dia­betes mel­lit­us, periph­er­al vas­cu­lar dis­ease and smok­ing hab­its. Surgical treat­ment was select­ed in 7 out of 16 ­screened ­patients. The remain­ing 9 ­patients with small-sized abdom­i­nal aor­tic aneu­rysms have been care­ful­ly fol­lowed up.
Conclusions. Screening for abdom­i­nal aor­tic aneu­rysm using ultra­sound is advis­able espe­cial­ly for male par­tic­i­pants and for the detec­tion of iliac aneu­rysms. This screen­ing pro­ce­dure is use­ful for early detec­tion ­because the ­screened aneu­rysm is gen­er­al­ly small-sized and impal­pa­ble.

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