Discontinuous, staccato growth of abdominal aortic aneurysms
Discontinuous, staccato growth of abdominal aortic aneurysms
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DOI：
10.1016/j.jamcollsurg.2004.07.031
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发表时间：
2004-11-01
影响因子：
5.2
通讯作者：
Santiago, C
中科院分区：
文献类型：
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作者：
Kurvers, H;Veith, FJ;Santiago, C
背景：评价腹主动脉瘤(AAA)在个体患者中的生长是连续的还是不连续的(断续)。研究设计：1996年至2002年，609例未破裂的腹主动脉瘤患者。其中278例得到了及时修复，331例得到了观察。在这项研究中，我们纳入了52名患者(后一组的16%)，他们至少进行了四次CT扫描，并在没有任何干预的情况下观察了18个月或更长时间。腹主动脉增长被定义为在任何观察期内直径大于或等于3 mm的任何增长(S)。AAA无生长定义为至少6个月无生长。断续生长被定义为至少一个非生长期和至少一个生长期。结果：52例患者的平均年龄为75+/-8岁(SD)。平均观察期42+/-20个月，平均腹主动脉直径生长率为3.6+/-2.4 mm/年，52例患者中仅12例(23%)表现为持续生长。34例患者(65%)出现断续生长。6例(12%)在18~57个月(平均30个月)内无生长。在整个观察期内，AAA的起始直径与个体生长率之间没有相关性(R=0.04，p=0.46)。结论：个体AAA的行为通常表现为不生长和生长交替的时期，即断续生长。有些动脉瘤可能有很长一段时间不生长。因此，管理层的决策不能建立在观察到的AAA增长率可以外推以预测未来增长率的假设基础上。(C)2004年由美国外科医师学会主办)。
BACKGROUND: To evaluate whether abdominal aortic aneurysm (AAA) growth in individual patients can be characterized as continuous or discontinuous (staccato).STUDY DESIGN: From 1996 to 2002, 609 patients presented with unruptured AAAs. Of these, 278 underwent prompt repair and 331 were observed. In this study, we included 52 patients (16% of the latter group) who had at least four CT scans and were observed for 18 months or longer without any intervention. AAA growth was defined as any increase in diameter of greater than or equal to 3 mm over any observation period(s). AAA nongrowth was defined as absence of growth for at least 6 months. Staccato growth was defined as at least one period of nongrowth combined with at least one period of growth.RESULTS: The 52 patients had a mean age of 75 +/- 8 (SD) years. The mean observation period was 42 +/- 20 months and the mean AAA diameter growth rate was 3.6 +/- 2.4 mm/y. Only 12 of these 52 patients (23%) demonstrated continuous growth. Staccato growth occurred in 34 patients (65%). Six patients (12%) showed no growth at all over 18 to 57 months (mean 30 months). No correlation was observed between initial diameter of AAAs and a patient's individual growth rate during the whole observation period (R = 0.04, p = 0.46).CONCULSIONS: Individual AAA behaviour is usually characterized by periods of nongrowth alternating with periods of growth, ie, staccato growth. Some aneurysms may have long periods of nongrowth. Accordingly, management decisions cannot be based on the presumption that observed growth rates of AAAs can be extrapolated to predict future growth rates. ((C) 2004 by the American College of Surgeons).