Fornasari Anna, Kuntz Salomé, Martini Chiara, Perini Paolo, Cabrini Elisa, Freyrie Antonio, Lejay Anne, Chakfé Nabil
Vascular Surgery, Cardio-Thoracic and Vascular Department, Parma University Hospital, 43126 Parma, Italy.
Vascular Surgery, Kidney Transplantation and Innovation, Department of Vascular Surgery, University Hospital of Strasbourg, 67085 Strasbourg, France.
Diagnostics (Basel). 2024 May 19;14(10):1053. doi: 10.3390/diagnostics14101053.
Vascular calcifications in aorto-iliac arteries are emerging as crucial risk factors for cardiovascular diseases (CVDs) with profound clinical implications. This systematic review, following PRISMA guidelines, investigated methodologies for measuring these calcifications and explored their correlation with CVDs and clinical outcomes. Out of 698 publications, 11 studies met the inclusion criteria. In total, 7 studies utilized manual methods, while 4 studies utilized automated technologies, including artificial intelligence and deep learning for image analyses. Age, systolic blood pressure, serum calcium, and lipoprotein(a) levels were found to be independent risk factors for aortic calcification. Mortality from CVDs was correlated with abdominal aorta calcification. Patients requiring reintervention after endovascular recanalization exhibited a significantly higher volume of calcification in their iliac arteries. Conclusions: This review reveals a diverse landscape of measurement methods for aorto-iliac calcifications; however, they lack a standardized reproducibility assessment. Automatic methods employing artificial intelligence appear to offer broader applicability and are less time-consuming. Assessment of calcium scoring could be routinely employed during preoperative workups for risk stratification and detailed surgical planning. Additionally, its correlation with clinical outcomes could be useful in predicting the risk of reinterventions and amputations.
主-髂动脉的血管钙化正逐渐成为心血管疾病（CVD）的关键危险因素，具有深远的临床意义。本系统评价遵循PRISMA指南，研究了测量这些钙化的方法，并探讨了它们与CVD及临床结局的相关性。在698篇出版物中，有11项研究符合纳入标准。总体而言，7项研究采用了手动方法，而4项研究采用了自动化技术，包括用于图像分析的人工智能和深度学习。年龄、收缩压、血清钙和脂蛋白（a）水平被发现是主动脉钙化的独立危险因素。CVD死亡率与腹主动脉钙化相关。血管腔内再通术后需要再次干预的患者，其髂动脉钙化体积明显更高。结论：本综述揭示了主-髂动脉钙化测量方法的多样性；然而，它们缺乏标准化的可重复性评估。采用人工智能的自动方法似乎具有更广泛的适用性且耗时较少。在术前检查中常规采用钙评分评估进行风险分层和详细的手术规划。此外，其与临床结局的相关性可能有助于预测再次干预和截肢的风险。
