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Review
. 2024 May 19;14(10):1053.
doi: 10.3390/diagnostics14101053.

Objective Methods to Assess Aorto-Iliac Calcifications: A Systematic Review

Anna Fornasari  1 , Salomé Kuntz  2   3 , Chiara Martini  4   5 , Paolo Perini  1   5 , Elisa Cabrini  1 , Antonio Freyrie  1   5 , Anne Lejay  2   3 , Nabil Chakfé  2   3
Affiliations
Review

Objective Methods to Assess Aorto-Iliac Calcifications: A Systematic Review

Anna Fornasari et al. Diagnostics (Basel). .

Abstract

Vascular calcifications in aorto-iliac arteries are emerging as crucial risk factors for cardiovascular diseases (CVDs) with profound clinical implications. This systematic review, following PRISMA guidelines, investigated methodologies for measuring these calcifications and explored their correlation with CVDs and clinical outcomes. Out of 698 publications, 11 studies met the inclusion criteria. In total, 7 studies utilized manual methods, while 4 studies utilized automated technologies, including artificial intelligence and deep learning for image analyses. Age, systolic blood pressure, serum calcium, and lipoprotein(a) levels were found to be independent risk factors for aortic calcification. Mortality from CVDs was correlated with abdominal aorta calcification. Patients requiring reintervention after endovascular recanalization exhibited a significantly higher volume of calcification in their iliac arteries. Conclusions: This review reveals a diverse landscape of measurement methods for aorto-iliac calcifications; however, they lack a standardized reproducibility assessment. Automatic methods employing artificial intelligence appear to offer broader applicability and are less time-consuming. Assessment of calcium scoring could be routinely employed during preoperative workups for risk stratification and detailed surgical planning. Additionally, its correlation with clinical outcomes could be useful in predicting the risk of reinterventions and amputations.

Keywords: aorto-iliac calcification; calcium score; vascular calcification.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart showing study selection to review methods employed for measuring vascular calcifications in the aorto-iliac arteries.
Figure 2
Figure 2
Different aorto-iliac plaques’ morphology: (a) irregular, protruding aortic plaque; (b) aortic circumferential plaque; (c) irregular and protruding bilateral iliac plaques; (d) circumferential plaque in right iliac, irregular, and protruding plaque in left iliac.
See this image and copyright information in PMC

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