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Three-dimensional ultrasound improves identification of patients with abdominal aortic aneurysms reaching the threshold for repair

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Three-dimensional ultrasound is a reliable alternative in endovascular aortic repair surveillance

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. An addition to the systematic review of simulation in open abdominal aortic aneurysm repair

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  3. Clinical validation of three-dimensional ultrasound for abdominal aortic aneurysm

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Mortality and complications after aortic bifurcated bypass procedures for chronic aortoiliac occlusive disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Three-dimensional ultrasound is a reliable alternative in endovascular aortic repair surveillance

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Validation of an assessment tool for estimation of abdominal aortic aneurysm compression in diagnostic ultrasound

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Effect of revascularization on lower extremity muscle function in combined type 2 diabetes and critical limb threatening ischemia

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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OBJECTIVE: Conventional two-dimensional ultrasound (2D-US) has been the recommended and preferred modality for the diagnosis and surveillance of abdominal aortic aneurysms (AAAs). Measurement of the aneurysm diameter using three-dimensional ultrasound (3D-US) has shown promising results in a research setting, improving agreement and reproducibility. However, studies evaluating 3D-US in a clinical context are lacking, which could hinder the optimal usage of this new modality. In the present study, we investigated the clinical value of 3D-US for AAA surveillance compared with the current standard 2D-US examination.

METHODS: Data from 126 patients with infrarenal AAAs <50 mm and 55 mm (female and male, respectively) were available for analysis. Eligibility was determined using the standard 2D-US anteroposterior (AP) diameter with a dual-plane technique. All the patients had subsequently undergone additional 3D-US and computed tomography angiography (CTA). Using CTA as the reference standard, the maximal standard 2D-US AP diameter was compared with that from 3D-US.

RESULTS: All 126 AAAs were, per the inclusion criteria, small, with no intervention indicated. With the addition of 3D-US imaging to the 2D-US-based surveillance program, the AAA diameter threshold (50 and 55 mm) was exceeded for 31 of the 126 patients (25%). These 31 patients were withdrawn from the present study and referred for treatment planning. Compared with the CTA AP diameter (mean, 49 ± 7.2 mm), the mean 3D-US AP diameter (mean, 49 ± 6.7 mm) was significantly more accurate than the standard mean 2D-US AP diameter (45 ± 6.2 mm; kappa value, 0.86 ± 0.05; 95% confidence interval, 0.76-0.96; kappa value, 0.01 ± 0.04; 95% confidence interval, -0.05 to 0.09, respectively).

CONCLUSIONS: For clinical use, the AAA diameter assessment using 3D-US was significantly more accurate than that with 2D-US and can substantially change the clinical management, from surveillance to operative treatment, for approximately one fourth of patients with an AAA. Further studies evaluating the clinical consequences of the 2D to 3D paradigm shift in AAA diagnostics are warranted, including sensitivity, specificity, agreement, and reproducibility estimation.

OriginalsprogEngelsk
TidsskriftJournal of Vascular Surgery
Vol/bind74
Udgave nummer5
Sider (fra-til)1644-1650
Antal sider7
ISSN0741-5214
DOI
StatusUdgivet - nov. 2021

Bibliografisk note

Copyright © 2021. Published by Elsevier Inc.

ID: 67939989