Studzińska Dorota, Rudel Bogusław, Polok Kamil, Lewandowski Krzysztof, Studziński Krzysztof, Gajdosz Anna, Oo Aung, Szczeklik Michał, Zaczek Marcin, Zaniewski Maciej, Szczeklik Wojciech
Department of Internal Diseases and Angiology, St. John Grande Hospital, Kraków, Poland.
Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.
Ann Vasc Surg. 2019 Jul;58:248-254.e1. doi: 10.1016/j.avsg.2018.10.044. Epub 2019 Feb 2.
The aim of our study is to assess the prevalence of concomitant arterial abnormalities (true aneurysms of iliac, common femoral, renal, visceral arteries and stenoses of iliac and renal arteries) in patients with abdominal aortic aneurysm, and to evaluate whether the type of the aneurysm (suprarenal versus solely infrarenal) is associated with this prevalence.
In this retrospective cross-sectional study, we assessed computed tomography angiography scans of 933 patients with abdominal aortic aneurysm, including thoracoabdominal aortic aneurysms type II-IV, with no history of abdominal aortic surgery. We compared 2 groups of patients: group 1 (n = 859) with solely infrarenal abdominal aortic aneurysm and group 2 (n = 74) with the suprarenal aneurysm component. Patients with history of aortic dissection or thoracoabdominal aortic aneurysms type I and V were excluded from the study. All computed tomography angiography scans were visually assessed by 2 independent experienced physicians.
Study group comprised 933 patients with the median age of 73.0 years, 83.8% of whom were male. We observed higher prevalence of common iliac artery aneurysms (44.6% vs. 30.6%, P = 0.013), internal iliac artery aneurysms (28.4% vs. 18.0%, P = 0.03), common femoral artery aneurysms (13.5% vs. 4.4%, P < 0.001), visceral artery aneurysms (5.4% vs. 1.2%, P = 0.019), renal artery stenosis (20.3% vs. 5.2%, P < 0.001), renal atrophy (6.7% vs. 1.1%, P = 0.004), and severe chronic kidney disease (14.1% vs. 1.8%, P < 0.001) in group 2 compared to group 1. There were no significant differences in the prevalence of iliac arterial stenoses between the groups.
Among patients with abdominal aortic aneurysm, concomitant aneurysms and renal artery stenosis are more common in patients with suprarenal component when compared to those with solely infrarenal presentation.
我们研究的目的是评估腹主动脉瘤患者中合并动脉异常（髂动脉、股总动脉、肾动脉、内脏动脉真性动脉瘤以及髂动脉和肾动脉狭窄）的患病率，并评估动脉瘤类型（肾上型与仅肾下型）是否与该患病率相关。
在这项回顾性横断面研究中，我们评估了933例腹主动脉瘤患者的计算机断层扫描血管造影（CTA）扫描结果，其中包括II-IV型胸腹主动脉瘤患者，且这些患者无腹主动脉手术史。我们比较了两组患者：第1组（n = 859）为仅肾下腹主动脉瘤患者，第2组（n = 74）为包含肾上动脉瘤成分的患者。有主动脉夹层病史或I型和V型胸腹主动脉瘤患者被排除在研究之外。所有CTA扫描均由2名独立的经验丰富的医生进行视觉评估。
研究组包括933例患者，中位年龄为73.0岁，其中83.8%为男性。我们观察到，与第1组相比，第2组中髂总动脉瘤（44.6%对30.6%，P = 0.013）、髂内动脉瘤（28.4%对18.0%，P = 0.03）、股总动脉瘤（13.5%对4.4%，P < 0.001）、内脏动脉瘤（5.4%对1.2%，P = 0.019）、肾动脉狭窄（20.3%对5.2%，P < 0.001）、肾萎缩（6.7%对1.1%，P = 0.004）以及严重慢性肾脏病（14.1%对1.8%，P < 0.001）的患病率更高。两组间髂动脉狭窄的患病率无显著差异。
在腹主动脉瘤患者中，与仅为肾下型表现的患者相比，包含肾上成分的患者合并动脉瘤和肾动脉狭窄更为常见。
