Small abdominal aortic aneurysms rupture risk factors and prediction based on wall stress assessment
| Autoři | |
|---|---|
| Rok publikování | 2014 |
| Druh | Další prezentace na konferencích |
| Fakulta / Pracoviště MU | |
| Citace | |
| Popis | Introduction: According guidelines when a diameter of asymptomatic AAA is less than 5.5 cm the patient is dispensarized, if it´s more a repair is indicated. In literature stands, that 10-24 % of ruptured AAA are less than 5.5 cm in diameter. Our main goal was to determine the portion of patients with small ruptured AAA repaired in our center between the years 2009 and 2012 and try to identify potential risk factors for rupture. Secondary goal was to show our experience with computer the wall stress analysis of AAA and thus predict its rupture risk. Materials/Methods: There was 41 cases (male n=32, female n=9) of urgent repair of ruptured AAA in our center in years 2009-2012. The maximal diameters of all ruptured AAA were measured from CT finding. In addition we compared data from patients medical history (smoking, hypertension, COPD, DM). Those data were statistically tested to reveal a relation with a diameter of ruptured AAA. We also performed a pioneer study of computer wall stress analysis of one risk patient dispensarized with AAA in cooperation with company Vascops GmbH (Graz, Austria). Results: Out of 41 patients with ruptured AAA there were 7 with the diameter less than 5.5 cm (male n=6, female n=1, totally 17.1 %). Average value of diameter was 8.4 cm. Average patient age was 74.9 years. Patients with COPD had the maximal diameter of their ruptured AAA significantly bigger (p=0.047). Majority of patients with ruptured AAA had a hypertension (n=38). There was no difference in diameter of ruptured AAA between male and female (p=0.487), but females lived to the higher age before the rupture (p=0.04). The diameter of AAA in our wall stress analysis was 5.4 cm, but it´s rupture risk equivalent diameter was only 4.5 cm, which means that the risk of rupture was equal to AAA 1 cm smaller Conclusion: 17.1 % of ruptured AAA treated in our center during the years 2009-2012 were less than 5.5 cm in diameter. Thus not a negligible portion of dispensarized patients would be in danger of a life-threatening rupture. The stress of our tested AAA was lower than the diameter could suggest (equal to 1 cm smaller AAA). The result supported continuing in dispensarization rather than performing a repair. Quest to find better method of AAA rupture prediction is continuing. |