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. SETTING: patients treated in a university hospital. SUBJECTS: 40 patients who underwent bifurcated graft bypass operation for AIOD without an abdominal aortic aneurysm =or>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.
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. SETTING:patients treated in a university hospital. SUBJECTS: 40 patients who underwent bifurcated graft bypass operation for AIOD without an abdominal aortic aneurysm =or>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.
Authors: G A Laughlin; M A Allison; N E Jensky; V Aboyans; N D Wong; R Detrano; M H Criqui Journal: Eur J Vasc Endovasc Surg Date: 2011-01-14 Impact factor: 7.069