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Stroke was defined as a documented history of ischemic or hemorrhagic stroke. Ischemic heart disease, hypertension and diabetes were defined as a previous diagnosis or treatment of these conditions by a qualified medical physician. Relevant medical history and clinical measurements were collected. Exclusion criteria included patients with a history of previous abdominal aortic surgery.Īn interview and physical examination were done upon recruitment. Participants met the following inclusion criteria: (1) a small infra-renal AAA measuring 30–55 mm in maximal diameter and (2) an ultrasound performed by one of three experienced vascular sonographers using a standardized protocol.
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MATERIALS AND METHODSĪ convenience sample size of 50 participants was used. Therefore, this study was done to compare the inter-and intra-observer repeatability of five different methods of measuring AAA diameter using distinct measurement planes and caliper placement. This leads to implications on decision-making regarding surgical repair and surveillance intervals which could impact outcome. Such different methods of caliper placement can cause differences of up to 5 mm in maximal AAA diameter. AAA screening programs have used a variety of different methods to measure AAA diameter on ultrasound, including the inner-to-inner (ITI) or leading edge-to-leading-edge (LETLE) methods of caliper placement. However, they were limited due to measurement protocols that were incompletely reported and vary in both plane of acquisition and caliper placement. Several previous clinical trials using ultrasound imaging were done with an attempt to estimate maximum AAA diameter. Current guidelines recommend considering AAA repair when the maximum diameter is ≥ 55 mm in men and ≥ 50 mm in women.
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It is also used in clinical practice to guide decision-making. The maximum AAA diameter is used to predict AAA growth and rupture. For people older than 65 years, abdominal aortic aneurysm (AAA) occurs in about 2% of men and 0.5 % of women.