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International Angiology 2004 December;23(4):373-8

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English

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


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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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