Real-world abdominal aorta aneurysm screening patterns among patients with new or worsening of symptomatic peripheral artery disease

Background: Patients with peripheral artery disease (PAD) have an increased risk of abdominal aortic aneurysms (AAA), but it remains unclear whether practitioners are screening patients for AAA as part of routine PAD management.Methods: The Patient-centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease (PORTRAIT) Registry is an international prospective registry of patients with new or worsening PAD symptoms presenting to 16 specialty centers in the United States, Netherlands, and Australia, from June 2011 to December 2015. Patients were stratified by AAA screening or AAA positivity. An adjusted median odds ratio was calculated for AAA screening rates across sites.Results: Of the 1275 patients in the study, 871 (68%) were screened for AAA, with 53 (6.1%) having AAA. AAA screening rates did not differ significantly by country (p = 0.36), but there was a large variation across sites for documentation of AAA screening with an adjusted median odds ratio 12.0 (95% CI 4.7-93.1), with AAA screening rates ranging from 7% to 100% across vascular specialty centers.Conclusions: Among patients with PAD in a multicenter registry, over two-thirds were screened for AAA, with 6% having documented aneurysms. A large variation was seen across clinical sites, suggesting efforts are needed to increase awareness for guideline implementation and establish new benefit-risk evidence inclusive of high-risk populations such as patients with PAD.

Automated summary

This study investigates whether patients with peripheral artery disease (PAD) are being screened for abdominal aortic aneurysms (AAA). The results show that approximately 68% of patients were screened for AAA, with about 6.1% having AAA. While there were no significant differences in AAA screening rates between different countries, there was a large variation between different healthcare institutions, highlighting the need for more efforts in guideline implementation and evidence-building for high-risk populations, including patients with PAD.