Incidence of Finding Abdominal Aortic Aneurysm in Abdominal Computed Tomography Scan and its Implication on its Prevalence in Saudi Arabia

Background: In Saudi Arabia, the number of thoracic and abdominal aortic aneurysms (AAAs) treated does not exceed 200/year. For a population of over 30 million, this number is far below international standards. The lack of studies on incidence of AAA in the gulf has left many questioning whether AAA is massively underdiagnosed or whether the prevalence is inferior to international standards. We designed a study to estimate the prevalence of AAA in our region. Methods: This was a retrospective review of all abdominal computer technologies (CTs) done from January 1, 2011, to December 31, 2016, in our hospital. We included all male patients at age 65–75 years in whom a CT was done for reasons other than diagnosing and managing aortic aneurysms. All external aortic diameters of 3 cm or more were considered positive for AAA. Results: The total number of reviewed CTs was 2032. The mean age was 69.8 ± 3.1 years and the mean aortic size was 1.9 ± 0.3 cm. There were 2026 cases (99.7%) with sizes <3 cm and the mean age was 69.8 ± 3.1 years. There were six cases (0.3%) with sizes ≥3 cm and the mean age was 72.3 ± 3.1 years. The only statistically significant factor for AAA was age, 69.8 versus 72.3 ± 3.1 years (P = 0.0433). Conclusion: Based on our data, the number of AAA in our population is inferior to most international screening programs. This low incidence could explain the far inferior number of diagnosed AAA in our population, and there are a number of scientific theories to support this result. However, these data are from a tertiary referral center, and many risk factors for AAA were not available. A pilot screening program in the nonhospital population would provide more robust evidence on the need of an AAA screening program.

Publication History

Article published online:
11 May 2021