Information is incomplete about the rate of expansion of abdominal aortic aneurysms and the risk of rupture in relation to their size. To address these questions, we conducted a population-based study. Of the 370 residents of Rochester, Minn., with an aneurysm initially diagnosed from 1951 through 1984, 181 had the aneurysm documented by ultrasound examination. Among the 103 patients who underwent more than one ultrasound study, the diameter of the aneurysm increased by a median of 0.21 cm per year. Only 24 percent had a rate of expansion of 0.4 cm or more per year. Among the 176 patients who had an unruptured aneurysm at the time of the initial ultrasound study, the cumulative incidence of rupture was 6 percent after 5 years and 8 percent after 10 years. However, the risk of rupture over five years was 0 percent for the 130 patients with an aneurysm less than 5 cm in diameter and 25 percent for the 46 patients with an aneurysm 5 cm or more in diameter. All 16 patients who had ruptures had aneurysms that were 5 cm or more in diameter at the time of the rupture. These population-based data challenge the clinical perception that aneurysms typically expand at a rate of 0.4 to 0.5 cm per year. Our data also suggest that for aneurysms less than 5 cm in diameter the risk of rupture is considerably lower than has been reported previously. However, the risk of rupture is substantial for aneurysms 5 cm or more in diameter.
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Section of Clinical Epidemiology, Mayo Clinic, Rochester, Minn 55905.
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346: 1437-1444
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5: 187-193
[Abstract]
Hara, A. K., Johnson, C. D., MacCarty, R. L., Welch, T. J.
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215: 353-357
[Abstract][Full Text]
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(2000). Yield of Repeated Screening for Abdominal Aortic Aneurysm After a 4-Year Interval. Arch Intern Med
160: 1117-1121
[Abstract][Full Text]
Bayazit, M., Gol, M K., Iscan, H Z., Ulus, T., Tasdemir, O., Bayazit, K.
(1999). Is Surgery Justifiable for Treatment of Small Abdominal Aortic Aneurysms?. Asian Cardiovasc. Thorac. Ann.
7: 200-203
[Abstract][Full Text]
Lederle, F. A., Simel, D. L.
(1999). Does This Patient Have Abdominal Aortic Aneurysm?. JAMA
281: 77-82
[Abstract][Full Text]
Lalka, S. G., Johnson, M. S., Stockberger, S. M.
(1999). Evaluation of Abdominal Aortic Aneurysms. PERSPECT VASC SURG ENDOVASC THER
10: 43-68
[Abstract]
Taylor, M. D., Wilson, S. E.
(1999). Should We Operate on Aortic Aneurysms under 5 . 5 cm?. PERSPECT VASC SURG ENDOVASC THER
12: 99-111
[Abstract]
Reed, W. W., Hallett, J. W. Jr, Damiano, M. A., Ballard, D. J.
(1997). Learning From the Last Ultrasound: A Population-Based Study of Patients With Abdominal Aortic Aneurysm. Arch Intern Med
157: 2064-2068
[Abstract]
Matsumura, J. S., Pearce, W. H., Yusuf, S. W., Wenham, P., Hopkinson, B. R., Hoch, R. C., Blum, U., Beyersdorf, F., Ernst, C. B.
(1997). Infrarenal Aortic Aneurysms. NEJM
336: 1756-1758
[Full Text]
Kiev, J., Eckhardt, A., Kerstein, M. D.
(1997). Reliability and Accuracy of Physical Examination in Detection of Abdominal Aortic Aneurysms. VASC ENDOVASCULAR SURG
31: 143-146
[Abstract]
Lederle, F. A.
(1996). Risk of Rupture of Large Abdominal Aortic Aneurysms: Disagreement Among Vascular Surgeons. Arch Intern Med
156: 1007-1009
[Abstract]
Hans, S. S., Zeskind, H. J.
(1995). Routine Use of Limited Abdominal Aortography With Digital Subtraction Carotid and Cerebral Angiography. Stroke
26: 1221-1224
[Abstract][Full Text]
Hirose, Y., Hamada, S., Takamiya, M.
(1995). Predicting the Growth of Aortic Aneurysms: A Comparison of Linear vs Exponential Models. ANGIOLOGY
46: 413-419
[Abstract]
Ruiz, C. E., Zhang, H. P., Douglas, J. T., Zuppan, C. W., Kean, C. J.C.
(1995). A Novel Method for Treatment of Abdominal Aortic Aneurysms Using Percutaneous Implantation of a Newly Designed Endovascular Device. Circulation
91: 2470-2477
[Abstract][Full Text]
Masclans, J. R., Planas, M., Bermejo, B., Serra, J., Porta, I., Sobregrau, R., de Latorre, F. J.
(1994). Ruptured Abdominal Aortic Aneurysms: Morbidity and Mortality Rates in 80 Consecutive Cases. VASC ENDOVASCULAR SURG
28: 459-466
[Abstract]
Dapunt, O. E., Galla, J. D., Sadeghi, A. M., Lansman, S. L., Mezrow, C. K., de Asla, R. A., Quintana, C., Wallenstein, S., Ergin, A. M., Griepp, R. B.
(1994). The natural history of thoracic aortic aneurysms. J. Thorac. Cardiovasc. Surg.
107: 1323-1333
[Abstract][Full Text]
Ballard, D. J., Nevitt, M. P., Steinmann, A. F., Caramore, W., Walston, J., Finucane, T., Ernst, C. B.
(1993). Abdominal Aortic Aneurysm. NEJM
329: 1275-1277
[Full Text]
Ernst, C. B.
(1993). Abdominal Aortic Aneurysm. NEJM
328: 1167-1172
[Full Text]
Trotter, M. C., Ilabaca, P. A.
(1993). Ruptured Abdominal Aortic Aneurysms: A Retrospective Look at a Ten-Year Interval. VASC ENDOVASCULAR SURG
27: 183-186
[Abstract]
Katz, D. A., Littenberg, B., Cronenwett, J. L.
(1992). Management of Small Abdominal Aortic Aneurysms: Early Surgery vs Watchful Waiting. JAMA
268: 2678-2686
[Abstract]
BALLARD, D. J., HALLETT, J. W. JR
(1990). Positive-Predictive Value of Clinical Suspicion of Abdominal Aortic Aneurysm-Reply. Arch Intern Med
150: 2592-2594
[Abstract]
Krupski, W. C., Bass, A., Thurston, D. W., Dilley, R. B., Bernstein, E. F.
(1990). Utility of Computed Tomography for Surveillance of Small Abdominal Aortic Aneurysms: Preliminary Report. Arch Surg
125: 1345-1350
[Abstract]
Beede, S. D., Ballard, D. J., James, E. M., Ilstrup, D. M., Hallet, J. W. Jr
(1990). Positive Predictive Value of Clinical Suspicion of Abdominal Aortic Aneurysm: Implications for Efficient Use of Abdominal Ultrasonography. Arch Intern Med
150: 549-551
[Abstract]
(1989). PROGNOSIS OF ABDOMINAL AORTIC ANEURYSMS BASED ON SIZE. JWatch General
1989: 4-4
[Full Text]
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