Accuracy of Point-of-Care Ultrasound in Follow Up Abdominal Aortic Aneurysm Imaging

Ankur Gupta; Désiré M Kindarara; Kevin C Chun; Sandipan Datta; Richard C Anderson; Zachary T Irwin; Elise A Newton; Eugene S Lee

doi:10.1177/15385744221099093

Accuracy of Point-of-Care Ultrasound in Follow Up Abdominal Aortic Aneurysm Imaging

Vasc Endovascular Surg. 2022 Apr 28:15385744221099093. doi: 10.1177/15385744221099093. Online ahead of print.

Authors

Ankur Gupta¹, Désiré M Kindarara², Kevin C Chun¹, Sandipan Datta¹, Richard C Anderson¹, Zachary T Irwin¹, Elise A Newton¹, Eugene S Lee³

Affiliations

¹ Department of Research, 19981Sacramento Veterans Affairs Medical Center, Mather, CA, USA.
² Patient Care Services, & Department of Research, Sacramento Veterans Affairs Medical Center, Mather, CA, USA; College of Health and Human Services/School of Nursing at California State University, Sacramento (CSUS), Sacramento, CA, USA.
³ Department of Surgery, Sacramento Veterans Affairs Medical Center, Mather, CA, USA.

PMID: 35484796
DOI: 10.1177/15385744221099093

Abstract

Background: Point-of-care ultrasound (POCUS) has been reported as a valuable tool for bedside diagnoses of abdominal Aortic Aneurysms (AAA). However, no data exist regarding POCUS in measuring follow-up AAA diameter studies in patients with existing AAAs. The purpose of this study was to determine the variability of aortic measurements performed by a non-physician using POCUS vs standard of care (SOC) measurements by a registered vascular technologist or an abdominal/pelvic CT scan.

Methods: A prospective observational ultrasound study was performed from 1/1/2019 to 3/31/2021 on patients with a diagnosis of an AAA (≥3.0 cm). A research coordinator (non-physician) underwent a 3-hour training session in ultrasound operation and basic human anatomy to measure AAA diameter. The maximum aortic diameter was documented and compared to measurements obtained by SOC ultrasonography or CT scan. The POCUS and SOC ultrasounds were separated by no more than 90 days. Clinical risk factors including age, race, body mass index, coronary artery disease, hypertension, peripheral vascular disease, cerebrovascular disease, diabetes, and current smoking were also collected.

Results: Eighty-one patients (mean age: 73.6 ± 5.8 years, body mass index: 29.5 ± 6.2 kg/m²) were being followed in a vascular clinic and underwent both a POCUS and SOC ultrasounds. One indeterminant study was reported in identifying an AAA diagnosis, due to an overlying colostomy. The average follow-up time from initial screening aortic diameter to POCUS was 4.4 ± 3.7 years. Overall average aortic diameter measurements obtained were 4.1 ± .9 cm for POCUS and 4.0 ± .9 cm for SOC (P = NS). Average difference in aortic measurement for POCUS and SOC was -.1 ± .3 cm.

Conclusions: POCUS is an accurate method to follow AAA diameter in patients. POCUS could improve patient follow up with AAA diameter measurements, streamline care and reduce overall burden for both patients and Radiology Departments in assessing follow up AAA diameters.

Keywords: aneurysm; lost to follow-up; mass screening; point-of-care systems; standard of care; ultrasonography; veterans.