Olukorode John O, Onwuzo Chidera N, Otabor Emmanuel O, Nwachukwu Nwachukwu O, Omiko Raymond, Omokore Olutomiwa, Kristilere Heritage, Oladipupo Yetunde, Akin-Adewale Rolake, Kuku Oluwatosin, Ugboke Joshua O, Joseph-Erameh Thummim
Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA.
Internal Medicine, University Hospital Coventry and Warwickshire, Coventry, GBR.
Cureus. 2024 Apr 21;16(4):e58673. doi: 10.7759/cureus.58673. eCollection 2024 Apr.
Abdominal aortic aneurysms (AAAs) pose significant challenges in clinical management, particularly in female patients, whose unique anatomical and physiological characteristics influence rupture risk. While aortic diameter (AD) has traditionally been the primary metric for predicting rupture, its limitations, especially in women, have spurred exploration into alternative measures such as the aortic size index (ASI). This review examines the anatomy and physiology of AAAs in women, gender-specific challenges in diagnosis and management, and the comparative effectiveness of ASI versus AD in predicting rupture risk. ASI, calculated as AD divided by body surface area (BSA), offers a more nuanced assessment by adjusting for individual body size differences, potentially mitigating gender disparities in rupture rates. Comparative analyses indicate ASI's superiority in predicting adverse aortic events, particularly in women, thereby advocating for its integration into clinical practice to improve patient outcomes. Additionally, emerging techniques such as 3D volumetric measurements and biomechanical assessments show promise in enhancing rupture risk prediction, heralding a shift toward more personalized and effective management strategies for AAA patients.
腹主动脉瘤(AAA)在临床管理中面临重大挑战,尤其是在女性患者中,其独特的解剖和生理特征会影响破裂风险。虽然主动脉直径(AD)传统上一直是预测破裂的主要指标,但其局限性,特别是在女性中,促使人们探索诸如主动脉大小指数(ASI)等替代指标。本综述探讨了女性腹主动脉瘤的解剖学和生理学、诊断和管理中特定性别的挑战,以及ASI与AD在预测破裂风险方面的比较有效性。ASI通过将AD除以体表面积(BSA)来计算,通过调整个体体型差异提供了更细致入微的评估,有可能减轻破裂率方面的性别差异。比较分析表明ASI在预测主动脉不良事件方面具有优势,尤其是在女性中,因此主张将其纳入临床实践以改善患者预后。此外,诸如三维容积测量和生物力学评估等新兴技术在提高破裂风险预测方面显示出前景,预示着向更个性化和有效的腹主动脉瘤患者管理策略的转变。