72315 - Point Of Care Ultrasound (POCUS) in screening for Abdominal Aortic Aneurysm: a comparative, cohort study

Introduction Screening for abdominal aortic aneurysm (AAA) performed with ultrasound (US) in men reduces AAA-related mortality. Ambulatory screening and surveillance procedures could improve adherence to screening programs. Point Of Care Ultrasound (POCUS) could facilitate ambulatory screening for AAA. The aim of this study was to assess whether the infrarenal aortic diameter (IAD) in a screening setting could be measured interchangeably with POCUS compared to standard ultrasound equipment. Method A comparative cohort study was conducted of men screened for AAA at the age of 65 with IAD measured to ≥25-29 mm. The cohort was invited to re-examination 5-12 years after screening. Three measurements of IAD each were conducted with a standard US (LOGIQTM, GE) device and POCUS (LumifyTM, Philips) device. Limits of agreement between the devices and repeatability for each device were calculated. Result At screening, 500 men had IAD of ≥25–29 mm. With 102 men deceased at follow-up (FU), 230 men attended the examination. Median FU was 9.9 years (interquartile range [IQR]: 8.0-11.0). Median IAD was 27.1 mm, (IQR: 23.7-32.8). POCUS underestimated IAD by 0.23 mm compared to the standard ultrasound machine, 95% limits of agreement were -3.1 mm to 2.6 mm between the devices. The repeatability was ± 2.5 mm for standard equipment and ± 3.2 mm for handheld device. Discussion The handheld device showed no systematic bias of clinical importance in measuring IAD in a screening setting although with a slightly wider repeatability interval compared to standard US equipment implying the possibility to consider POCUS devices for AAA-screening purposes.