title: A multicentre observational study of the outcomes of screening detected sub-aneurysmal aortic dilatation.
abstract: OBJECTIVE
  Currently most abdominal aortic aneurysm screening programmes discharge patients with aortic diameter of less than 30 mm. However, sub-aneurysmal aortic dilatation (25 mm-29 mm) does not represent a normal aortic diameter. This observational study aimed to determine the outcomes of patients with screening detected sub aneurysmal aortic dilatation.
  
  
  METHODS
  Individual patient data was obtained from 8 screening programmes that had performed long term follow up of patients with sub aneurysmal aortic dilatation. Outcome measures recorded were the progression to true aneurysmal dilatation (aortic diameter 30 mm or greater), progression to size threshold for surgical intervention (55 mm) and aneurysm rupture.
  
  
  RESULTS
  Aortic measurements for 1696 men and women (median age 66 years at initial scan) with sub-aneurysmal aortae were obtained, median period of follow up was 4.0 years (range 0.1-19.0 years). Following Kaplan Meier and life table analysis 67.7% of patients with 5 complete years of surveillance reached an aortic diameter of 30 mm or greater however 0.9% had an aortic diameter of 54 mm. A total of 26.2% of patients with 10 complete years of follow up had an AAA of greater that 54 mm.
  
  
  CONCLUSIONS
  Patients with sub-aneurysmal aortic dilatation are likely to progress and develop an AAA, although few will rupture or require surgical intervention.
authors.affiliation: Department of Cardiovascular Sciences, Vascular Surgery Group, University of Leicester, Leicester, UK. benw@doctors.org.uk
authors.forename: J B
authors.initials: JB
authors.lastname: Wild
authors.forename: P W
authors.initials: PW
authors.lastname: Stather
authors.forename: F
authors.initials: F
authors.lastname: Biancari
authors.forename: E C
authors.initials: EC
authors.lastname: Choke
authors.forename: J J
authors.initials: JJ
authors.lastname: Earnshaw
authors.forename: S W
authors.initials: SW
authors.lastname: Grant
authors.forename: H
authors.initials: H
authors.lastname: Hafez
authors.forename: R
authors.initials: R
authors.lastname: Holdsworth
authors.forename: T
authors.initials: T
authors.lastname: Juvonen
authors.forename: J
authors.initials: J
authors.lastname: Lindholt
authors.forename: C
authors.initials: C
authors.lastname: McCollum
authors.forename: S
authors.initials: S
authors.lastname: Parvin
authors.forename: R D
authors.initials: RD
authors.lastname: Sayers
authors.forename: M J
authors.initials: MJ
authors.lastname: Bown
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001019:Aortic Rupture / Q000209:etiology / Q000473:pathology; D004108:Dilatation, Pathologic; D018450:Disease Progression; D005060:Europe; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography; D014656:Vascular Surgical Procedures