Adherence to SVS Abdominal Aortic Aneurysm Guidelines Among Patients Detected by AI-Based Algorithm

• Published in: Annals of vascular surgery Vol. 120; pp. 108 - 114
• Main Authors: Wilson, Elena M., Yao, Kaelan, Kostiuk, Valentyna, Bader, Justin, Loh, Sarah, Mojibian, Hamid, Fischer, Uwe, Ochoa Chaar, Cassius Iyad, Aboian, Edouard
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.11.2025
• Subjects: Aged; Aged, 80 and over; Algorithms; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - surgery; Artificial Intelligence; Decision Support Techniques; Female; Guideline Adherence - standards; Humans; Male; Natural Language Processing; Practice Guidelines as Topic - standards; Practice Patterns, Physicians' - standards; Predictive Value of Tests; Retrospective Studies; Risk Factors; Time Factors; Vascular Surgical Procedures - standards
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1016/j.avsg.2025.05.007

This study evaluates adherence to the latest Society for Vascular Surgery (SVS) guidelines on imaging surveillance, physician evaluation, and surgical intervention for abdominal aortic aneurysm (AAA). Artificial intelligencebased (AI-based) natural language processing was applied to imaging scans from retrospectively identified AAA patients at a tertiary care center between January and March 2019 and 2021, excluding the pandemic period. Retrospective chart review assessed demographics, comorbidities, imaging, and follow-up adherence. Statistical significance was set at P < 0.05. Among 479 identified patients, 279 remained in the final cohort following exclusion of deceased patients. Imaging surveillance adherence was 67.7% (189/279), with males comprising 72.5% (137/189). The mean age for adherent patients was 73.9 (SD ± 9.5) vs. 75.2 (SD ± 10.8) for nonadherent patients. Adherent females were significantly younger than nonadherent females (76.7 vs. 81.1 years; P = 0.003) with no significant age difference in adherent males. Adherent patients were more likely to be evaluated by a vascular provider within 6 months (P < 0.001), but aneurysm size did not affect imaging adherence: 3.0–4.0 cm (P = 0.24), 4.0–5.0 cm (P = 0.88), > 5.0 cm (P = 0.29). Based on SVS surgical criteria, 18 males (AAA > 5.5 cm) and 17 females (AAA > 5.0 cm) qualified for intervention and repair rates increased in 2021. Thirty four males (20 in 2019 vs. 14 in 2021) and 7 females (2021 only) received surgical intervention below the threshold for repair. Despite consistent SVS guidelines, adherence remains moderate. AI-based detection and follow-up algorithms may enhance adherence and long-term AAA patient outcomes, however further research is needed to assess the specific impacts of AI. •279/479 AIDOC patients were analyzed for adherence with SVS AAA guidelines.•Adherent patients more likely to see a vascular provider within 6 months.•Adherent patients more likely imaged for known AAA than for other indications.•AI-based algorithms may help improve guideline adherence in AAA patients.