The relationship between aortic wall distensibility and rupture of infrarenal abdominal aortic aneurysm

K. A. Wilson, Amanda Jane Lee, P. R. Hoskins, F. G. Fowkes, C. V. Ruckley, A. W. Bradbury

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

Objective: A more accurate means of prediction of abdominal aortic aneurysm (AAA) rupture would improve the clinical and cost effectiveness of prophylactic repair. The purpose of this study was to determine whether AAA wall distensibility can be used to predict time to rupture independently of other recognized risk factors.

Methods. A prospective, six-center study of 210 patients with AAA in whom blood pressure (BP), maximum AAA diameter (Dmax), and AAA distensibility (pressure strain elastic modulus [Ep] and stiffness [beta]) were measured at 6 months with an ultrasound scan-based echo-tracking technique. A stepwise, time-dependent, Cox proportional hazards model was used to determine the effect on time to rupture of age, gender, BP, Dmax, BP, Ep, beta, and change in Dmax, Ep, and beta adjusted for time between follow-up visits.

Results: Median (interquartile range) AAA diameter was 48 mm (41 to 54 mm), median age was 72 years (68 to 77 years), and median follow-up period was 19 months (9 to 30 months). In the Cox model, female gender (hazards ratio [HR], 2.78; 95% CI, 1.23 to 6.28; P = .014), larger Dmax (HR, 1.36 for 10% increase in Dmax; 95% CI, 1.12 to 1.66; P = .002), higher diastolic BP (HP, 1.13 for 10% increase in BP; 95% CI, 1.13 to 1.92; P = .004), and a decrease in Ep (increase in distensibility) over time (HR, 1.38 for 10% decrease in Ep over 6 months; 95% CI, 1.08 to 1.78; P = .010) significantly reduced the time to rupture (had a shorter time to rupture).

Conclusion: Women have a shorter time to AAA rupture. The measurement of AAA distensibility, diastolic BP, and diameter may provide a more accurate assessment of rupture risk than diameter alone.

Original languageEnglish
Pages (from-to)112-117
Number of pages5
JournalJournal of Vascular Surgery
Volume37
DOIs
Publication statusPublished - 2003

Keywords

  • EXPERIENCE
  • DIAMETER
  • ARTERIES
  • RISK

Cite this

The relationship between aortic wall distensibility and rupture of infrarenal abdominal aortic aneurysm. / Wilson, K. A.; Lee, Amanda Jane; Hoskins, P. R.; Fowkes, F. G.; Ruckley, C. V.; Bradbury, A. W.

In: Journal of Vascular Surgery, Vol. 37, 2003, p. 112-117.

Research output: Contribution to journalArticle

Wilson, K. A. ; Lee, Amanda Jane ; Hoskins, P. R. ; Fowkes, F. G. ; Ruckley, C. V. ; Bradbury, A. W. / The relationship between aortic wall distensibility and rupture of infrarenal abdominal aortic aneurysm. In: Journal of Vascular Surgery. 2003 ; Vol. 37. pp. 112-117.
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abstract = "Objective: A more accurate means of prediction of abdominal aortic aneurysm (AAA) rupture would improve the clinical and cost effectiveness of prophylactic repair. The purpose of this study was to determine whether AAA wall distensibility can be used to predict time to rupture independently of other recognized risk factors.Methods. A prospective, six-center study of 210 patients with AAA in whom blood pressure (BP), maximum AAA diameter (Dmax), and AAA distensibility (pressure strain elastic modulus [Ep] and stiffness [beta]) were measured at 6 months with an ultrasound scan-based echo-tracking technique. A stepwise, time-dependent, Cox proportional hazards model was used to determine the effect on time to rupture of age, gender, BP, Dmax, BP, Ep, beta, and change in Dmax, Ep, and beta adjusted for time between follow-up visits.Results: Median (interquartile range) AAA diameter was 48 mm (41 to 54 mm), median age was 72 years (68 to 77 years), and median follow-up period was 19 months (9 to 30 months). In the Cox model, female gender (hazards ratio [HR], 2.78; 95{\%} CI, 1.23 to 6.28; P = .014), larger Dmax (HR, 1.36 for 10{\%} increase in Dmax; 95{\%} CI, 1.12 to 1.66; P = .002), higher diastolic BP (HP, 1.13 for 10{\%} increase in BP; 95{\%} CI, 1.13 to 1.92; P = .004), and a decrease in Ep (increase in distensibility) over time (HR, 1.38 for 10{\%} decrease in Ep over 6 months; 95{\%} CI, 1.08 to 1.78; P = .010) significantly reduced the time to rupture (had a shorter time to rupture).Conclusion: Women have a shorter time to AAA rupture. The measurement of AAA distensibility, diastolic BP, and diameter may provide a more accurate assessment of rupture risk than diameter alone.",
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T1 - The relationship between aortic wall distensibility and rupture of infrarenal abdominal aortic aneurysm

AU - Wilson, K. A.

AU - Lee, Amanda Jane

AU - Hoskins, P. R.

AU - Fowkes, F. G.

AU - Ruckley, C. V.

AU - Bradbury, A. W.

PY - 2003

Y1 - 2003

N2 - Objective: A more accurate means of prediction of abdominal aortic aneurysm (AAA) rupture would improve the clinical and cost effectiveness of prophylactic repair. The purpose of this study was to determine whether AAA wall distensibility can be used to predict time to rupture independently of other recognized risk factors.Methods. A prospective, six-center study of 210 patients with AAA in whom blood pressure (BP), maximum AAA diameter (Dmax), and AAA distensibility (pressure strain elastic modulus [Ep] and stiffness [beta]) were measured at 6 months with an ultrasound scan-based echo-tracking technique. A stepwise, time-dependent, Cox proportional hazards model was used to determine the effect on time to rupture of age, gender, BP, Dmax, BP, Ep, beta, and change in Dmax, Ep, and beta adjusted for time between follow-up visits.Results: Median (interquartile range) AAA diameter was 48 mm (41 to 54 mm), median age was 72 years (68 to 77 years), and median follow-up period was 19 months (9 to 30 months). In the Cox model, female gender (hazards ratio [HR], 2.78; 95% CI, 1.23 to 6.28; P = .014), larger Dmax (HR, 1.36 for 10% increase in Dmax; 95% CI, 1.12 to 1.66; P = .002), higher diastolic BP (HP, 1.13 for 10% increase in BP; 95% CI, 1.13 to 1.92; P = .004), and a decrease in Ep (increase in distensibility) over time (HR, 1.38 for 10% decrease in Ep over 6 months; 95% CI, 1.08 to 1.78; P = .010) significantly reduced the time to rupture (had a shorter time to rupture).Conclusion: Women have a shorter time to AAA rupture. The measurement of AAA distensibility, diastolic BP, and diameter may provide a more accurate assessment of rupture risk than diameter alone.

AB - Objective: A more accurate means of prediction of abdominal aortic aneurysm (AAA) rupture would improve the clinical and cost effectiveness of prophylactic repair. The purpose of this study was to determine whether AAA wall distensibility can be used to predict time to rupture independently of other recognized risk factors.Methods. A prospective, six-center study of 210 patients with AAA in whom blood pressure (BP), maximum AAA diameter (Dmax), and AAA distensibility (pressure strain elastic modulus [Ep] and stiffness [beta]) were measured at 6 months with an ultrasound scan-based echo-tracking technique. A stepwise, time-dependent, Cox proportional hazards model was used to determine the effect on time to rupture of age, gender, BP, Dmax, BP, Ep, beta, and change in Dmax, Ep, and beta adjusted for time between follow-up visits.Results: Median (interquartile range) AAA diameter was 48 mm (41 to 54 mm), median age was 72 years (68 to 77 years), and median follow-up period was 19 months (9 to 30 months). In the Cox model, female gender (hazards ratio [HR], 2.78; 95% CI, 1.23 to 6.28; P = .014), larger Dmax (HR, 1.36 for 10% increase in Dmax; 95% CI, 1.12 to 1.66; P = .002), higher diastolic BP (HP, 1.13 for 10% increase in BP; 95% CI, 1.13 to 1.92; P = .004), and a decrease in Ep (increase in distensibility) over time (HR, 1.38 for 10% decrease in Ep over 6 months; 95% CI, 1.08 to 1.78; P = .010) significantly reduced the time to rupture (had a shorter time to rupture).Conclusion: Women have a shorter time to AAA rupture. The measurement of AAA distensibility, diastolic BP, and diameter may provide a more accurate assessment of rupture risk than diameter alone.

KW - EXPERIENCE

KW - DIAMETER

KW - ARTERIES

KW - RISK

U2 - 10.1067/mva.2003.40

DO - 10.1067/mva.2003.40

M3 - Article

VL - 37

SP - 112

EP - 117

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

ER -