title: Discontinuous, staccato growth of abdominal aortic aneurysms.
abstract: BACKGROUND
  To evaluate whether abdominal aortic aneurysm (AAA) growth in individual patients can be characterized as continuous or discontinuous (staccato).
  
  
  METHODS
  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 >/= 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).
  
  
  CONCLUSIONS
  Individual AAA behavior 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.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Harrie
authors.initials: H
authors.lastname: Kurvers
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Veith
authors.forename: Evan C
authors.initials: EC
authors.lastname: Lipsitz
authors.forename: Takao
authors.initials: T
authors.lastname: Ohki
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Gargiulo
authors.forename: Neal S
authors.initials: NS
authors.lastname: Cayne
authors.forename: William D
authors.initials: WD
authors.lastname: Suggs
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Timaran
authors.forename: Grace Y
authors.initials: GY
authors.lastname: Kwon
authors.forename: Soo J
authors.initials: SJ
authors.lastname: Rhee
authors.forename: Christian
authors.initials: C
authors.lastname: Santiago
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed