Vol 14, No 1-2 (2012)
Original articles
Published online: 2012-11-19
Ultrasound screening of aortic aneurysm and aorto-iliac occlusion detection in males living in Wielkopolska province
Chirurgia Polska 2012;14(1-2):3-13.
Abstract
Introduction: In previous study was demonstrated the usefulness of screening with use of ultrasonography
in reducing the mortality caused by the rupture of abdominal aortic aneurysms (AAA).
The aim of this study was to determine the prevalence of aneurysms of the aorta and iliac graft occlusions
in the population of men aged over 50 years, living in Wielkopolska province, with risk factors for
vascular complications, using ultrasound imaging.
Material and methods: The analysis included 313 men aged 52–89 years surveyed in the period from March 2009 to January 2010, aged 65 years, with at least one factor of cardiovascular complications development, or aged over 50 years, with positive family history of AAA. Every subject underwent physical examination and ankle-brachial index, serum glucose and lipids were estimated. Also Doppler-duplex of aortic and iliac arteries was performed.
Results: In 14 patients (4.5%) AAA of 32–93 mm diameter were detected. Two patients with symptomatic aneurysms were candidates for urgent surgical treatment. In patients with AAA significantly higher levels of glucose, increased frequency of current smoking, history of stroke and the presence of chronic obstructive pulmonary disease and systemic diseases, were found. In 11 patients (3.5%) were detected aorto-iliac occlusion, including 2 cases with critical ischemia symptoms. These individuals were characterized by higher concentrations of total cholesterol and LDL cholesterol, lower HDL cholesterol concentrations and more frequent active smoking and history of strokes. Palpation sensitivity in the detection of AAA was 21% and ultrasound specificity 100%. Limited diagnostic value had 3.8% ultrasound examinations and 0.9% of this percentage required repetition. The diameter of aorta dilated segments assessed by ultrasound and CT angiography differed about 0–2.4 mm (mean 1.8 ± 0.6 mm).
Conclusions: This study confirmed that the incidence of abdominal aortic aneurysms development and their risk factors in the male population in Wielkopolska are similar to those described in earlier papers. AAA were detected in14 cases, of which two required urgent operation. The usefulness of abdominal ultrasonography in the detection of the AAA, was confirmed. The continuation of this screening program in a similar formula will be needed.
Material and methods: The analysis included 313 men aged 52–89 years surveyed in the period from March 2009 to January 2010, aged 65 years, with at least one factor of cardiovascular complications development, or aged over 50 years, with positive family history of AAA. Every subject underwent physical examination and ankle-brachial index, serum glucose and lipids were estimated. Also Doppler-duplex of aortic and iliac arteries was performed.
Results: In 14 patients (4.5%) AAA of 32–93 mm diameter were detected. Two patients with symptomatic aneurysms were candidates for urgent surgical treatment. In patients with AAA significantly higher levels of glucose, increased frequency of current smoking, history of stroke and the presence of chronic obstructive pulmonary disease and systemic diseases, were found. In 11 patients (3.5%) were detected aorto-iliac occlusion, including 2 cases with critical ischemia symptoms. These individuals were characterized by higher concentrations of total cholesterol and LDL cholesterol, lower HDL cholesterol concentrations and more frequent active smoking and history of strokes. Palpation sensitivity in the detection of AAA was 21% and ultrasound specificity 100%. Limited diagnostic value had 3.8% ultrasound examinations and 0.9% of this percentage required repetition. The diameter of aorta dilated segments assessed by ultrasound and CT angiography differed about 0–2.4 mm (mean 1.8 ± 0.6 mm).
Conclusions: This study confirmed that the incidence of abdominal aortic aneurysms development and their risk factors in the male population in Wielkopolska are similar to those described in earlier papers. AAA were detected in14 cases, of which two required urgent operation. The usefulness of abdominal ultrasonography in the detection of the AAA, was confirmed. The continuation of this screening program in a similar formula will be needed.
Keywords: abdominal aorta aneurysmscreeningabdominal ultrasonographyduplex examinationrisk factors
