Si pone in evidenza l'importanza dello screening nella popolazione per aneurismi dell'aorta addominale

Arici, Vittorio

Bozzani, Antonio

Franciscone, Mariamila

Ragni, Franco

Sterpetti, Antonio V

Ticozzelli, Giulia

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Sterpetti, Antonio V.

PubMed Central

The negative effects of reduced attention to standard guidelines for screening and surgery of abdominal aortic aneurysms during the coronavirus disease 2019 pandemic

Archivio della ricerca- Università di Roma La Sapienza

LETTERS TO THE EDITORTable. Prevalence of surgery for ruptured abdominalaortic aneurysms during the outbreak and no-outbreakperiods of coronavirus disease 2019 (COVID-19) infectionin comparison with previous years (P <.001)2010-2019 2020-2022The negative effects of reduced attention tostandard guidelines for screening andsurgery of abdominal aortic aneurysmsduring the coronavirus disease 2019pandemicTotal 189 27COVID-19 outbreak periodsAutumn 73 (38.6) 4 (14.8)Winter 50 (26.5) 3 (11.1)No COVID-19 outbreak periodsSpring 43 (22.7) 11 (40.7)Summer 23 (12.2) 9 (33.3)Values are number (%).We read with interest the article by Sullivan et al.1 Theauthors analyzed the Society for Vascular SurgeryVascular Quality Initiative registry from September2020 to February 2021,2,3 finding that the elective-nonelective rates of operations were not significantlydifferent from the historical value supposing little restric-tion in the performance of elective procedures.We have analyzed the number of patients who had sur-gery for ruptured abdominal aortic aneurysm (rAAA) inPavia in the 2 years of the pandemic (February 2020-February 2022). Twenty-seven patients underwentsurgery for rAAA. During the first year, 18 patients had sur-gery similarly to the previous 10 years (mean, 18.9 patientsper year). In the second year of the pandemic, only ninepatients had surgery for rAAA.We analyzed the number of patients who had surgeryduring the outbreak (14 months) and during the no-outbreak periods (10 months). In the 2 years of thepandemic, seven patients underwent surgery duringthe outbreak. In the same months of the previous10 years, the mean of operated patients for rAAA was32 every 2 years. During the no-outbreak periods(10 months), 20 patients underwent surgery with an in-crease of 25% in comparison with the mean of thesame period of the previous 10 years (16 patients every2 years) (P < .01) (Table).Of the 27 patients, 14 (52%) were not aware of theAAA. Five patients with an AAA with a maximumdiameter between 55 and 68 mm decided to post-pone the operation. The remaining eight patientshad an AAA with an initial maximum transverse diam-eter ranging from 32 to 54 mm (mean, 43 mm) andpostponed their ultrasound follow-up visit during thepandemic.During the outbreaks of coronavirus disease 2019, asignificant number of patients with rAAA might nothave reached the hospital.2,3 It is possible that the sim-ilarity between the ratio of elective and nonelective pro-cedures before and during the pandemic reported bySullivan et al may be misleading because a significantnumber of patients with rAAA did not reach thehospital.Our experience supports the importance to follow stan-dard guidelines as concern surgery for AAA.4-6Antonio Bozzani, MDVittorio Arici, MDGiulia Ticozzelli, MDMariamila Franciscone, MDFranco Ragni, MDAntonio V. Sterpetti, MDSapienza UniversityRome, ItalyREFERENCES1. Sullivan K, Mureebe L, Huffman K, Eldrup-Jorgensen J, Lemmon GW.Preliminary analysis of coronavirus disease 2019 variable insertion intoVascular Quality Initiative registries. J Vasc Surg 2022. doi: 10.1016/j.jvs.2022.06.009. Online ahead of print.2. Natarajan JP, Mahenthiran AK, Bertges DJ, Huffman KM, Eldrup-Jorgensen J, Lemmon GW. Effects of coronavirus disease 2019 on theSociety for Vascular Surgery Vascular Quality Initiative arterial pro-cedure registry. J Vasc Surg 2021;73:1852-7.3. Johnston LE, Robinson WP, Tracci MC, Kern JA, Cherry KJ, Kron IL, et al.Vascular Quality Initiative and National Surgical Quality ImprovementProgram registries capture different populations and outcomes inopen infrainguinal bypass. J Vasc Surg 2016;64:629-37.4. Bozzani A, Arici V, Ticozzelli G, Franciscone MM, Sterpetti AV, Ragni F.Increased rates of ruptured abdominal aortic aneurysm during theCOVID-19 pandemic. J Vasc Surg 2021;74:2119-20.5. Chaikof EL, Dalman RL, Eskandari MK, Jackson BM, Lee WA,Mansour MA, et al. The Society for Vascular Surgery practice guidelineson the care of patients with an abdominal aortic aneurysm. J VascSurg 2018;67:2-77.e2.6. Bozzani A, Arici V, Franciscone M, Ticozzelli G, Sterpetti AV, Ragni F.COVID-19 patients with abdominal aortic aneurysm may be at higherrisk for sudden enlargement and rupture. J Vasc Surg 2022;75:387-8.https://doi.org/10.1016/j.jvs.2022.08.039ReplyWe thank Sterpetti et al for their comments onruptured aneurysm frequency in Rome, Italy, during309

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The negative effects of reduced attention to standard guidelines for screening and surgery of abdominal aortic aneurysms during the coronavirus disease 2019 pandemic

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