ORIGINAL ARTICLES   

International Angiology 2000 June;19(2):152-7

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

A comparative study of iliac and abdominal aortic aneurysms

Vammen S., Lindholt J., Henneberg E. W., Fasting H.

From the Department of Vascular Surgery, Viborg Hospital, Denmark * Vascular Surgical Unit, Skejby Hospital, Aarhs, Denmark

Back­ground. The aim of the paper is to com­pare the epi­dem­i­ol­o­gy, risk fac­tors and man­i­fes­ta­tions of iliac and abdom­i­nal aor­tic aneu­rysms.
Meth­ods. Two stud­ies were used: 1. 5,470 65-73-year-old men invit­ed for screen­ing for abdom­i­nal aor­tic aneu­rysms. 2. ­Review of all 350 ­patients oper­at­ed on for cen­tral aneu­rysms in the ­county of ­Viborg, Den­mark from 1989-1997.
­Results. 4,176 attend­ed for screen­ing. One hun­dred and sev­en­ty (4.0%) had an abdom­i­nal aor­tic aneu­rysm. Twen­ty- one (0.56%) need­ed oper­a­tion. The pro­por­tion of ­patients with com­mon iliac aneu­rysms requir­ing sur­gery was 0.17%. The oper­a­tive inci­dence of iliac aneu­rysm was 18.4 per mil­lion per year, and 92.4 per mil­lion per year were oper­at­ed on for abdom­i­nal aor­tic aneu­rysm. The mean serum cho­les­te­rol level for iso­lat­ed iliac aneu­rysm and com­bined aneu­rysms was sig­nif­i­cant­ly lower com­pared to iso­lat­ed abdom­i­nal aor­tic aneu­rysm (p<0.05). Uro­log­i­cal symp­toms were ­present in 42% of cases with iso­lat­ed iliac aneu­rysm, and 25% of com­bined aneu­rysms com­pared to 8% of iso­lat­ed abdom­i­nal aor­tic aneu­rysms. Fifty-eight per­cent of the iso­lat­ed iliac aneu­rysms were rup­tured, as ­against 27% of the abdom­i­nal aor­tic aneu­rysms. The peri- and post­op­er­a­tive mor­tal­ity was 57% in rup­tured iso­lat­ed iliac aneu­rysms, 47% in rup­tured com­bined aneu­rysms, and 31% in rup­tured iso­lat­ed aor­tic aneu­rysms.
Con­clu­sions. Iliac aneu­rysms seem to be more under­di­ag­nosed than abdom­i­nal aor­tic aneu­rysms, and are often diag­nosed ­because of clin­i­cal man­i­fes­ta­tions, espe­cial­ly uro­log­i­cal, or rup­ture. Iliac aneu­rysms seem more ­lethal than those of the abdom­i­nal aorta in cases of rup­ture.