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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2004 December;23(4):373-8

lingua: Inglese

Hemodynamic influence of peripheral vascular occlusive disease on abdominal aortic aneurysms

Hoshina K., Miyata T., Hatakeyama T., Shigematsu H., Nagawa H.

Divi­sion of Vas­cu­lar Sur­gery, Depart­ment of Sur­gery, Grad­u­ate ­School of Med­i­cine, Uni­ver­sity of Tokyo, Tokyo, Japan


Aim. Clin­i­cal evi­dence indi­cates that hemo­dy­nam­ic con­di­tions such as periph­er­al vas­cu­lar occlu­sive dis­ease (PVOD) influ­ence abdom­i­nal aor­tic aneu­rysm (AAA) dis­ease.
Meth­ods. We ret­ro­spec­tive­ly ana­lyzed 406 oper­at­ed cases of AAA at our insti­tute over the last 15 years, and com­pared 39 ­patients with PVOD to those with­out, to exam­ine hemo­dy­nam­ic ­effects and risk fac­tors. Aneu­rysm size at oper­a­tion, rup­ture, shape, expan­sion rate and sev­er­al pre­op­er­a­tive risk fac­tors were com­pared.
­Results. Mean aor­tic diam­e­ter in the AAA with PVOD ­patients (56.8±17.8 mm) ­showed no sig­nif­i­cant dif­fer­ence to that in the AAA with­out PVOD group (60.4±14.8 mm). How­ev­er, the sub­group of AAA with PVOD in whom the aneu­rysm was found prior to PVOD diag­no­sis (67.8±18.1 mm) (n=19) ­showed a larg­er mean AAA diam­e­ter com­pared to the AAA (not fol­lowed up until oper­a­tive indi­ca­tion/prior to oper­a­tion) with­out PVOD group (60.4±14.8 mm), (n=340), (p=0.04). Smok­ing was the only pre­op­er­a­tive risk fac­tor to show a dif­fer­ence ­between AAA ­patients with and with­out PVOD. The aneu­rysm expan­sion rate was deter­mined ret­ro­spec­tive­ly in 13 ­patients with PVOD who had been fol­lowed for at least 1 year by CT scan and 17 ­patients with­out PVOD. The rate in the PVOD group was 8.1 mm/year, which was sig­nif­i­cant­ly fast­er than that in PVOD-free ­patients (4.6 mm/year), (p=0.03).
Con­clu­sion. The find­ings of a large diam­e­ter and fast expan­sion rate in AAA ­patients with con­com­i­tant PVOD sug­gest that the hemo­dy­nam­ic ­effects of PVOD have a great influ­ence on AAA devel­op­ment.

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