ORIGINAL ARTICLES   

International Angiology 2002 September;21(3):222-7

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Infrarenal aortic dilatation less than 4 cm is not unusual in patients with aortoiliac occlusive disease

Matsushita M., Nishikimi N., Sakurai T., Nimura Y.

First Department of Surgery, Nagoya University, School of Medicine, Nagoya, Japan

Background. The rela­tion­ship ­between ath­ero­scler­o­sis ­and abdom­i­nal aor­tic aneu­rysm is ­now con­tro­ver­sial. To bet­ter ­define ­the con­tri­bu­tion of ath­ero­scler­o­sis to ­the devel­op­ment of aneu­rysm of ­the infra­ren­al aor­ta, we deter­mined ­the inci­dence of aor­tic dil­a­ta­tion in ­patients under­go­ing arte­ri­al recon­struc­tion ­for an ath­e­ros­cle­rot­ic aor­toi­liac occlu­sive dis­ease (­AIOD). The ­role of aor­tic ­wall cal­cifi­ca­tion ­and intra­lu­mi­nal throm­bus ­was ­also deter­mined.
Methods. Setting: patients treat­ed in a uni­ver­sity hos­pi­tal. Subjects: 40 ­patients ­who under­went bifur­cat­ed ­graft ­bypass oper­a­tion ­for AIOD with­out an abdom­i­nal aor­tic aneu­rysm ≥4 cm in ­size. Measures: Diameter, lumi­nal cal­cifi­ca­tion ­and intra­lu­mi­nal throm­bus of ­the infra­ren­al aor­ta ­were eval­u­at­ed ­using pre­op­er­a­tive con­trast enhance­ment com­put­ed tomog­ra­phy.
Results. Sixteen ­patients (40%) ­had an infra­ren­al aor­ta larg­er ­than ­the aor­ta at ­the lev­el of ­the ­left ­renal ­vein. Of ­these, 5 ­patients (12.5%) ­had a 50% enlarge­ment or ­more. Infrarenal aor­tic diam­e­ter cor­re­lat­ed neg­a­tive­ly ­with ­the ­extent of cal­cifi­ca­tion of ­the infra­ren­al aor­ta ­and pos­i­tive­ly ­with ­the ­amount of intra­lu­mi­nal throm­bus.
Conclusions. Infrarenal aor­tic dil­a­ta­tion ­less ­than 4 cm in ­size is ­not unusu­al in ­patients ­with AIOD, sug­gest­ing a pos­sible rela­tion­ship ­between aor­tic ath­ero­scler­o­sis ­and dil­a­ta­tion. An aor­ta ­with ath­e­ros­cle­rot­ic ­plaque con­tain­ing abun­dant throm­bus ­and ­few cal­cifi­ca­tions ­may devel­op enlarge­ment.