The prevalence of Abdominal Aortic Aneurysm (AAA): an ultrasound screening program for the aging population in multicentre across Riyadh
File(s)
Author(s)
Algadi, Arwa Saad
Type
Thesis
Abstract
Introduction: Abdominal aortic aneurysm (AAA) is characterized by permanent dilatation of the aortic wall. If it ruptures, fatality rates might exceed 80%. Screening elderly men for AAA is cost-effective and decreases mortality rates in Western nations. In Saudi Arabia, little research has been conducted. Establishing a screening program might lower AAA rupture mortality risk. Because of their lower cost, and compact size, handheld ultrasound devices may be suitable for mass screening. Shear wave elastography (SWE) has emerged as a tool for assessing the elastic properties of the aortic wall, improving AAA diagnosis.
Hypothesis: This research aimed to determine AAA prevalence in the elderly population of Riyadh city and investigate associated risk factors, examine elastic properties of aneurysmal aortic walls using SWE, and assess the reliability of the Butterfly iQ probe as a diagnostic tool.
Methods: Three prospective analytic investigations were carried out. The first study screened individuals (n=680) for AAA across multiple hospitals in Riyadh. The second research utilized SWE ultrasound to evaluate participants' aortas. In the last study, two operators scanned AAA patients using conventional and Butterfly probes.
Results: The study revealed a prevalence of 1% (95% CI 0.4% - 2.1%) and a high association between AAA and male gender and smoking, a significant difference in wall stiffness between AAA cases and controls (p <0.001), and Intra- and inter-operator interclass correlation coefficient (ICC) values greater than 0.9, indicating excellent agreement. The Bland-Altman limits of agreement were similar for both methods.
Conclusion: The prevalence of AAA in Riyadh is trending similarly to Western nations. National screening for AAA should be considered and investigated. Advances in ultrasound technologies have increased surveillance capabilities, and changes in aortic wall elasticity may be early warning signs. The Butterfly iQ probe is effective in detecting AAA, potentially replacing conventional ultrasound machines in community mass screenings.
Hypothesis: This research aimed to determine AAA prevalence in the elderly population of Riyadh city and investigate associated risk factors, examine elastic properties of aneurysmal aortic walls using SWE, and assess the reliability of the Butterfly iQ probe as a diagnostic tool.
Methods: Three prospective analytic investigations were carried out. The first study screened individuals (n=680) for AAA across multiple hospitals in Riyadh. The second research utilized SWE ultrasound to evaluate participants' aortas. In the last study, two operators scanned AAA patients using conventional and Butterfly probes.
Results: The study revealed a prevalence of 1% (95% CI 0.4% - 2.1%) and a high association between AAA and male gender and smoking, a significant difference in wall stiffness between AAA cases and controls (p <0.001), and Intra- and inter-operator interclass correlation coefficient (ICC) values greater than 0.9, indicating excellent agreement. The Bland-Altman limits of agreement were similar for both methods.
Conclusion: The prevalence of AAA in Riyadh is trending similarly to Western nations. National screening for AAA should be considered and investigated. Advances in ultrasound technologies have increased surveillance capabilities, and changes in aortic wall elasticity may be early warning signs. The Butterfly iQ probe is effective in detecting AAA, potentially replacing conventional ultrasound machines in community mass screenings.
Version
Open Access
Date Issued
2023-08
Date Awarded
2024-03
Copyright Statement
Creative Commons Attribution NonCommercial Licence
License URL
Advisor
Aslam, Mohammed
Bicknell, Collin
Sponsor
Princess Norah Bint Abdulrahman University
Publisher Department
Department of Surgery & Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)