{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:59:34Z","timestamp":1791313174868,"version":"4.3.1"},"reference-count":35,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>There has been a debate about whether maximum diameter can be solely used to assess the natural history of abdominal aortic aneurysm. The aim of the present review is to collect all the available evidence on the role of abdominal aortic aneurysm (AAA) volume in the natural history of AAAs, including small untreated AAAs and AAAs treated by EVAR. The current literature appears to reinforce the role of volume as a supplementary measure for evaluating the natural history of AAA, in both intact AAAs and after EVAR. The clinical impact of AAA volume measurements remains unclear. Several studies show that volumetric analysis can assess changes in AAAs and predict successful endoluminal exclusion after EVAR more accurately than diameter. However, most studies lack strict standardized measurement criteria and well-defined outcome definitions. It remains unclear whether volumetry could replace diameter assessment in defining the risk of rupture of AAAs and identifying clinically relevant sac growth.<\/jats:p>","DOI":"10.3390\/jcm13010193","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T03:28:41Z","timestamp":1703820521000},"page":"193","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5443-2066","authenticated-orcid":false,"given":"George","family":"Kouvelos","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Volakakis","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4872-1811","authenticated-orcid":false,"given":"Konstantinos","family":"Dakis","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2891-777X","authenticated-orcid":false,"given":"Konstantinos","family":"Spanos","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Giannoukas","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ejvs.2018.09.020","article-title":"Editor\u2019s Choice\u2014European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms","volume":"57","author":"Wanhainen","year":"2019","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Martelli, E., Enea, I., Zamboni, M., Federici, M., Bracale, U.M., Sangiorgi, G., Martelli, A.R., Messina, T., and Settembrini, A.M. (2023). Focus on the Most Common Paucisymptomatic Vasculopathic Population, from Diagnosis to Secondary Prevention of Complications. Diagnostics, 13.","DOI":"10.20944\/preprints202305.0209.v1"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ejvs.2013.04.033","article-title":"Trans-Atlantic Debate: External Diameter for Abdominal Aortic Aneurysm (AAA)Size versus Volume","volume":"46","author":"Ricco","year":"2013","journal-title":"Eur. J. Vasc. Endovasc. Surg. Off. J. Eur. Soc. Vasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Nana, P., Spanos, K., Dakis, K., Brodis, A., and Kouvelos, G. (2021). Imaging Predictive Factors of Abdominal Aortic Aneurysm Growth. J. Clin. Med., 10.","DOI":"10.3390\/jcm10091917"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1177\/0003319719862965","article-title":"Small Abdominal Aortic Aneurysms Are Not All the Same","volume":"71","author":"Spanos","year":"2020","journal-title":"Angiology"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Vait\u0117nas, G., Mosenko, V., Ra\u010dyt\u0117, A., Medelis, K., Skreb\u016bnas, A., and Baltr\u016bnas, T. (2023). Abdominal Aortic Aneurysm Diameter versus Volume: A Systematic Review. Biomedicines, 11.","DOI":"10.3390\/biomedicines11030941"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jvs.2018.04.050","article-title":"Aneurysm sac failure to regress after endovascular aneurysm repair is associated with lower long-term survival","volume":"69","author":"Deery","year":"2019","journal-title":"J. Vasc. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"186","DOI":"10.23736\/S0021-9509.19.10878-6","article-title":"Tsilimparis NCurrent evidence on aortic remodeling after EVAR","volume":"60","author":"Kapetanios","year":"2019","journal-title":"J. Cardiovasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/S0741-5214(98)70065-5","article-title":"Rupture in small abdominal aortic aneurysms","volume":"28","author":"Nicholls","year":"1998","journal-title":"J. Vasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2249","DOI":"10.1097\/JS9.0000000000000433","article-title":"Comparing maximum diameter and volume when assessing the growth of small abdominal aortic aneurysms using longitudinal CTA data: Cohort study","volume":"109","author":"Ristl","year":"2023","journal-title":"Int. J. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ejrad.2009.12.018","article-title":"Comparison of Volume and Diameter Measurement in Assessing Small Abdominal Aortic Aneurysm Expansion Examined Using Computed Tomographic Angiography","volume":"79","author":"Parr","year":"2011","journal-title":"Eur. J. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1016\/j.ejrad.2011.01.077","article-title":"Aortic volume as an indicator of disease progression in patients with untreated infrarenal abdominal aneurysm","volume":"81","author":"Renapurkar","year":"2012","journal-title":"Eur. J. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/j.jvs.2021.09.046","article-title":"Role of Volume in Small Abdominal Aortic Aneurysm Surveillance","volume":"75","author":"Olson","year":"2022","journal-title":"J. Vasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.ejrad.2014.03.018","article-title":"Value of Volume Measurements in Evaluating Abdominal Aortic Aneurysms Growth Rate and Need for Surgical Treatment","volume":"83","author":"Kontopodis","year":"2014","journal-title":"Eur. J. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1177\/1526602819886568","article-title":"Anatomical Differences Between Intact and Ruptured Large Abdominal Aortic Aneurysms","volume":"27","author":"Spanos","year":"2020","journal-title":"J. Endovasc. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.ejvs.2017.06.016","article-title":"Follow-up on Small Abdominal Aortic Aneurysms Using Three Dimensional Ultrasound: Volume Versus Diameter","volume":"54","author":"Ghulam","year":"2017","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.avsg.2022.05.017","article-title":"Aneurysm Geometry Analyzed by the Novel Three-Dimensional Tomographic Ultrasound Relates to Abdominal Aortic Aneurysm Growth","volume":"87","author":"Khan","year":"2022","journal-title":"Ann. Vasc. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jvs.2017.10.044","article-title":"The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm","volume":"67","author":"Chaikof","year":"2018","journal-title":"J. Vasc. Surg."},{"key":"ref_19","first-page":"CD004178","article-title":"Endovascular repair of abdominal aortic aneurysm","volume":"1","author":"Paravastu","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1053\/ejvs.1999.1051","article-title":"Maximal aneurysm diameter follow-up is inadequate after endovascular abdominal aortic aneurysm repair","volume":"20","author":"Wever","year":"2000","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1583\/03-976.1","article-title":"Aortic Diameter Is an Insensitive Measurement of Early Aneurysm Expansion After Endografting","volume":"11","author":"Kritpracha","year":"2004","journal-title":"J. Endovasc. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1007\/s00270-004-0171-9","article-title":"Endovascular Repair of Abdominal Aortic Aneurysms: Analysis of Aneurysm Volumetric Changes at Mid-Term Follow-Up","volume":"28","author":"Bargellini","year":"2005","journal-title":"Cardiovasc. Intervent. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jvir.2017.09.012","article-title":"CT after Endovascular Repair of Abdominal Aortic Aneurysms: Diagnostic Accuracy of Diameter Measurements for the Detection of Aneurysm Sac Enlargement","volume":"29","author":"Schnitzbauer","year":"2018","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e530","DOI":"10.5114\/pjr.2019.91260","article-title":"Aortic sac enlargement after endovascular aneurysm repair: Volume-related changes and the impact of intraluminal thrombus","volume":"84","author":"Skrebunas","year":"2019","journal-title":"Pol. J. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.asjsur.2018.12.006","article-title":"Efficacy of Volumetric Analysis of Aorta as Surveillance Tool after EVAR","volume":"42","author":"Quan","year":"2019","journal-title":"Asian J. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.jvs.2021.03.034","article-title":"A Morphovolumetric Analysis of Aneurysm Sac Evolution after Elective Endovascular Abdominal Aortic Repair","volume":"74","author":"Franchin","year":"2021","journal-title":"J Vasc. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Kargul, M., Sk\u00f3rka, P., Gutowski, P., Kazimierczak, A., Wiernicki, I., and Rynio, P. (2023). Beyond Diameter: Enhancing Abdominal Aortic Aneurysm Surveillance with Volumetric Assessments after Endovascular Aneurysm Repair (EVAR). J. Clin. Med., 12.","DOI":"10.3390\/jcm12216733"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.ejvs.2018.07.029","article-title":"Contrast enhanced three dimensional ultrasound for intraluminal thrombus assessment in abdominal aortic aneurysms","volume":"56","author":"Ghulam","year":"2018","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lorenzen, U.S., Ghulam, Q.M., Rouet, L., Eldrup, N., Resch, T., and Eiberg, J.P. (Int. Angiol., 2023). Abdominal aortic aneurysms volume growth patterns with three-dimensional ultrasound, Int. Angiol., ahead of print.","DOI":"10.23736\/S0392-9590.23.05103-9"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.ejvs.2018.01.014","article-title":"The impact of centralisation and endovascular aneurysm repair on treatment of ruptured abdominal aortic aneurysms based on international registries","volume":"56","author":"Venermo","year":"2018","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jbiomech.2017.09.041","article-title":"Does elevated wall tension cause aortic aneurysm rupture? Investigation using a subject-specific heterogeneous model","volume":"64","author":"Chung","year":"2017","journal-title":"J. Biomech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1002\/bjs.11995","article-title":"Comparison of peak wall stress and peak wall rupture index in ruptured and asymptomatic intact abdominal aortic aneurysms","volume":"108","author":"Singh","year":"2021","journal-title":"Br. J. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1016\/j.ejrad.2011.04.044","article-title":"Measurements and detection of abdominal aortic aneurysm growth: Accuracy and reproducibility of a segmentation software","volume":"81","author":"Kauffmann","year":"2012","journal-title":"Eur. J. Radiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1583\/08-2478.1","article-title":"Intra- and interobserver variability of aortic aneurysm volume measurement with fast CTA postprocessing software","volume":"15","author":"Vincken","year":"2008","journal-title":"J. Endovasc. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.jvs.2022.03.891","article-title":"Fully automatic volume segmentation using deep learning approaches to assess aneurysmal sac evolution after infrarenal endovascular aortic repair","volume":"76","author":"Caradu","year":"2022","journal-title":"J. Vasc. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/1\/193\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:43:58Z","timestamp":1760132638000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/1\/193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,29]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["jcm13010193"],"URL":"https:\/\/doi.org\/10.3390\/jcm13010193","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,29]]}}}