Abstract 13479: Screening Abdominal Aortic Aneurysm (AAA) During Transthoracic Echocardiography (TTE): First Multicenter Study
Background - The screening of abdominal aortic aneurysm (AAA) is associated with reduced AAA-related mortality, but population screening is poorly implemented. Opportunistic screening during imaging for other indications might be efficient. Single-center series report AAA rates from 0.8% to 6.5% in patients undergoing transthoracic echocardiography (TTE), with disparities plausibly explained by selection bias. In this first multicenter study, we assessed the feasibility of AAA screening in patients undergoing TTE.
Methods - Seventy-nine centers participated in a nationwide survey during one week, in May 2011. All patients ≥65 yrs requiring TTE for any indication were included. Those with operated abdominal aorta were excluded. Time required for aorta imaging was recorded, along with participants’ demographic and clinical data. We defined AAA by an antero-posterior diameter of the infra-renal aorta ≥30 mm.
Results - Among 1382 consecutive patients, imaging of abdominal aorta was feasible in 96.8% of cases (N=1338), with a median delay of 1.7 minutes. A delay >3 minutes was reported only in 3.6% of cases. We found AAA in 50 patients (3.7%), of whom 15 had a known history of small AAA. The prevalence of unknown AAA (overall 2.7%) was higher in men than women (3.7% vs. 1.3%, p=0.007), especially after age of 85 (Figure 1). None of the female participants <75 yrs had AAA. We found no significant differences in terms of CVD risk factors between those with or without AAA. The ascending aorta measured during TTE was larger in those with unknown AAA (36.2 ± 4.7 vs. 34.0 ± 5.2 mm, p=0.006).
Conclusion - Rapid AAA screening after TTE is feasible and should be limited to men ≥65 yrs and women ≥75 yrs. In this first nationwide study, the prevalence of AAA was overall lower than most of previous single-center reports. This may also be in part due to a general trend for decreased AAA prevalence.
- © 2012 by American Heart Association, Inc.