Monitoring period may be increased for small thoracic aortic aneurysms considering their slow Growth rate: Study

UK: A recent study in the European Heart Journal has suggested that for small aneurysms, international guidelines should consider increasing monitoring intervals to 12 months and increasing intervention thresholds. Also, age, size, sex, growth, surgical risk, and patient characteristics should be considered in individualized decisions about surveillance/intervention. 

Chronic thoracic aortic aneurysm (CTAA) of the arch or descending thoracic aorta (DTA) if undiagnosed or neglected as aneurysms expand, is life-threatening. Aneurysm growth is related to dissection (tearing) or rupture of the aortic wall. After diagnosis, 6-month mortality in treated and untreated patients with CTAA is estimated to be 17.7% and 30%, respectively. 

Against the above background, Linda Sharples, Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK, and colleagues aimed to observe, describe, and evaluate the management and timing of intervention for patients with untreated thoracic aortic aneurysms. 

For this purpose, the researchers conducted a prospective study of UK National Health Service (NHS) patients aged ≥18 years, with new/existing arch or descending thoracic aortic aneurysms of ≥4 cm diameter. They were followed up until death, intervention, withdrawal, or July 2019.