Evaluation for abdominal aortic aneurysms is justified in patients with thoracic aortic aneurysms

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• 作者：Mariana R. DeFreitas ; Leslie E. Quint…
• 关键词：Aorta/aortic ; Aneurysm (abdominal aorta thoracic aorta) ; Imaging ; Computed tomography
• 刊名：The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：32
• 期：4
• 页码：647-653
• 全文大小：1,579 KB
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• 作者单位：Mariana R. DeFreitas (1)
  Leslie E. Quint (2) (6)
  Kuanwong Watcharotone (3)
  Bin Nan (4)
  Michael J. Ranella (5)
  Joanna R. Hider (5)
  Peter S. Liu (2)
  David M. Williams (2)
  Jonathan L. Eliason (6)
  Himanshu J. Patel (7)
  
  1. Medical School, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
  2. Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109-5030, USA
  6. Department of Surgery, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
  3. Michigan Institute for Clinical and Health Research, University of Michigan, 2800 Plymouth Road, Building 400, Ann Arbor, MI, 48109-2800, USA
  4. Department of Biostatistics, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
  5. Frankel Cardiovascular Center, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
  7. Department of Cardiac Surgery, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Netherlands
• ISSN：1573-0743

文摘

Aortic aneurysms are a significant cause of mortality, and the presence of multiple aneurysms may affect treatment plans. The purpose of this study was to determine the frequency of abdominal aortic aneurysms (AAAs) in patients with thoracic aortic aneurysms (TAAs) and to establish whether patient specific factors, such as gender and comorbidities, influenced the frequency of AAAs, thereby indicating if and when abdominal aortic evaluation is justified. Electronic medical records were reviewed from 1000 patients with a computed tomography (CT) angiogram of the chest and abdomen and a clinical diagnosis of TAA from Cardiac Surgery clinic between 2008 and 2013. 538 patients with history of aortic intervention, dissection, rupture or trauma were excluded. The frequency of AAAs among the 462 remaining patients was established, and statistical analysis was used to elucidate differences in frequency based on age, gender, comorbidities, and TAA location. Overall, 104 of 462 (22.5 %) patients with a TAA also had an AAA. There were significant differences in the frequency of AAA based on TAA location, age, and comorbidities. The following comorbidities showed positive associations with AAA using logistic regression analysis: age ≥65 (P < 0.0001; OR 30.1; CI 7.14–126.61), smoking history (P < 0.0001; OR 4.1; 2.35–7.30), and hypertension (P = 0.024; OR 2.1; CI 1.11–4.16). Aneurysms in the proximal/mid descending (P < 0.0001; OR 4.96; CI 2.32–10.61) and diaphragm level (P < 0.0001; OR 38.4; CI 14.71–100.15) of the aorta also showed a positive association with AAAs when adjusted for age and gender. AAA screening in patients with TAA is a reasonable, evidence-based option regardless of the TAA location, with the strongest support in patients >age 55, with systemic hypertension, a smoking history and/or a TAA in the descending thoracic aorta.