title: Fast track echo of abdominal aortic aneurysm using a real pocket-ultrasound device at bedside.
abstract: BACKGROUND
  Ultraminiaturization of echographic systems extraordinarily provides the image "within" the clinical examination. Abdominal aorta aneurysm (AAA) diagnosis based on conventional evaluation with a dedicated operator and ultrasound machine is still controversial due to the lack of evidence of the proposed management and guidelines' cost-effectiveness. We hypothesized that less expensive ultraportable devices could identify AAA with the same level of accuracy as conventional approaches.
  
  
  METHODS
  A first step of this study was to validate the VSCAN's image capabilities in patients referred to the vascular Doppler laboratory. Abdominal aorta measurements were performed by an experienced physician using conventional equipment followed by a second blinded physician using the ultraportable device VSCAN. Then, 204 patients hospitalized in our cardiology institute were prospectively included for a systematic screening of AAA at bedside using the VSCAN in order to determine the feasibility and impact of fast track evaluation compared to clinical examination.
  
  
  RESULTS
  A strong correlation was obtained between measurements of abdominal aorta diameters using the two ultrasound systems (r = 0.98, CI: 0.97-0.99, P < 0.001) with 100% of agreement for AAA diagnosis. In the second part of the study, visualization and measurement of the transverse diameter of the abdominal aorta was obtained in 199 patients, resulting in a feasibility of 97.5%. Among these patients, 18 AAAs were detected, which corresponds to a prevalence of 9%, whereas clinical evaluation did not detect any of them. Patients with AAA were more likely men (77.77% vs. 57.45%, P < 0.05) and hypertensive (88.8% vs. 56.9%, P < 0.05) as compared to those without AAA. Two patients with large AAA were quickly referred to the surgery department.
  
  
  CONCLUSIONS
  Considering its low cost, diagnostic accuracy, and widespread availability, screening for AAA using an ultraportable ultrasound device such as VSCAN by an experienced physician is promising and should be used as an extension of routine physical examination in vascular patients.
authors: Echocardiography Department, University of Bordeaux, Pessac, France.
authors: Marina
authors: M
authors: Dijos
authors: Yann
authors: Y
authors: Pucheux
authors: Marianne
authors: M
authors: Lafitte
authors: Patricia
authors: P
authors: Réant
authors: Alain
authors: A
authors: Prevot
authors: Aude
authors: A
authors: Mignot
authors: Laurent
authors: L
authors: Barandon
authors: Xavier
authors: X
authors: Roques
authors: Raymond
authors: R
authors: Roudaut
authors: Xavier
authors: X
authors: Pilois
authors: Stéphane
authors: S
authors: Lafitte
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D002648:Child; D003199:Computer Systems; D004452:Echocardiography / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008904:Miniaturization; D019095:Point-of-Care Systems; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity