Department of Vascular Surgery, Royal Stoke University Hospital, Stoke-on-Trent, UK.
Department of Vascular Surgery, "Democritus" University of Thrace, University General Hospital of Evros, Alexandroupolis, Greece.
Eur J Vasc Endovasc Surg. 2018 Apr;55(4):475-491. doi: 10.1016/j.ejvs.2018.01.003. Epub 2018 Feb 9.
Screening for abdominal aortic aneurysm (AAA) during transthoracic echocardiography (TTE) may be an effective targeted screening strategy.
The aim was to assess the feasibility of AAA screening during TTE and to estimate the prevalence of AAA in patients undergoing TTE.
Electronic bibliographic sources were interrogated using a combination of free text and controlled vocabulary searches to identify studies reporting on AAA screening during TTE. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. Fixed effect or random effects models were used to calculate pooled prevalence estimates.
Twenty observational cohort studies were identified reporting a total of 43,341 participants (23,291 men and 20,050 women). Hypertension was reported in 41% (95% CI 38-43), hypercholesterolemia in 31% (95% CI 29-32), diabetes mellitus in 20% (95% CI 19-22), and tobacco use in 37% (95% CI 35-38). The aorta was visualised in 86% (95% CI 84-88) of the screened population. The pooled prevalence of AAA in the entire screened population was 0.033 (95% CI 0.024-0.044). The pooled prevalence of AAA in men was 0.046 (95% CI 0.032-0.065) and in women it was 0.014 (95% CI 0.008-0.022). The mean age of participants in whom an AAA was detected ranged across the studies from 66 to 85 years. The mean diameter of the aneurysm identified ranged across the studies from 35 mm to 45 mm. Clinical outcomes in participants with a detected AAA were poorly reported.
Screening for AAA during TTE may identify a population group with a high risk of AAA in whom targeted screening may be beneficial. Further research is required to investigate the cost-effectiveness and clinical benefits of AAA screening in this setting.
经胸超声心动图（TTE）筛查腹主动脉瘤（AAA）可能是一种有效的靶向筛查策略。
评估 TTE 中 AAA 筛查的可行性，并估计 TTE 患者中 AAA 的患病率。
使用自由文本和受控词汇搜索的组合，对电子文献来源进行查询，以确定报告 TTE 中 AAA 筛查的研究。审查按照系统评价和荟萃分析的首选报告项目（PRISMA）标准进行。使用固定效应或随机效应模型计算汇总患病率估计值。
确定了 20 项观察性队列研究，共报告了 43341 名参与者（23291 名男性和 20050 名女性）。报告的高血压患病率为 41%（95%CI 38-43），高胆固醇血症患病率为 31%（95%CI 29-32），糖尿病患病率为 20%（95%CI 19-22），吸烟率为 37%（95%CI 35-38）。在接受筛查的人群中，86%（95%CI 84-88）的主动脉可见。整个筛查人群中 AAA 的总患病率为 0.033（95%CI 0.024-0.044）。男性的 AAA 患病率为 0.046（95%CI 0.032-0.065），女性的患病率为 0.014（95%CI 0.008-0.022）。在检测到 AAA 的参与者中，年龄范围从 66 岁到 85 岁。在研究中，检测到的动脉瘤的平均直径范围从 35 毫米到 45 毫米。在参与者中，关于检测到的 AAA 的临床结果的报告很差。
TTE 中 AAA 的筛查可能会发现一群 AAA 风险较高的人群，对其进行靶向筛查可能是有益的。需要进一步研究来探讨在这种情况下 AAA 筛查的成本效益和临床获益。
