scholarly journals Prevalence of abdominal aortic aneurysm and associated lower extremity artery aneurysm in men hospitalized for suspected or known cardiopulmonary disease

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anna Hohneck ◽  
Michael Keese ◽  
Gerhard Ruemenapf ◽  
Klaus Amendt ◽  
Hannelore Muertz ◽  
...  

Abstract Background AAA is a disease affecting predominantly male patients ≥65 years and its dreaded complications such as rupture led to population-based screening programs as preventive measure. Nonetheless, the supposed prevalence may have been overestimated, so that targeted screening of high risk populations may be more effective. This study was performed to evaluate the prevalence of abdominal aortic aneurysm (AAA) of an inpatient high-risk cohort and to estimate the co-prevalence of lower extremity arterial aneurysms. Methods Participants: 566 male inpatients, ≥ 65 years of age, hospitalized for suspected or known cardiopulmonary disease. Primary and secondary outcome measures: Maximal infrarenal aortic diameters using abdominal ultrasound (leading edge to leading edge method). Upon detection of an AAA (diameter ≥ 30 mm), the lower extremity arteries were examined with regard to associated aneurysms. Results In 40 of 566 patients (7.1%) AAAs were detectable. Fourteen patients (2.5%) had a first diagnosis of AAA, none of which was large (> 55 mm), the remaining 26 patients were either already diagnosed (14 patients, 2.5%) or previously repaired (12 patients, 2.1%). The three most common main diagnoses at discharge were acute coronary syndrome (43.3%), congestive heart failure (32.2%), and chronic obstructive pulmonary disease (12%). The cohort showed a distinct cardiovascular risk profile comprising arterial hypertension (82.9%), diabetes mellitus (44.4%), and a history of smoking (57.6%). In multivariate analysis, three-vessel coronary artery disease (Odds ratio (OR): 4.5, 95% confidence interval (CI): 2.3–8.9, p <  0.0001) and history of smoking (OR: 3.7, CI: 1.6–8.6, p <  0.01) were positively associated with AAA, while diabetes mellitus (OR: 0.5, CI: 0.2–0.9, p = 0.0295) showed a negative association with AAA. Among the subjects with AAA, we found two large iliac and two large popliteal aneurysms. Conclusion Ultrasound screening in male inpatients, hospitalized for suspected or known cardiopulmonary disease, revealed a high AAA prevalence in comparison to the present epidemiological screening programs. There was a moderate proportion of newly-screen detected AAA and additional screening of the lower extremity arteries yielded some associated aneurysms with indication for possible intervention.

2011 ◽  
Vol 93 (4) ◽  
pp. e1-e2 ◽  
Author(s):  
Rachael O Forsythe ◽  
Victoria Lavin ◽  
Simon CA Fraser ◽  
Alan McNeill

Abdominal aortic aneurysm (AAA) rupture commonly presents with abdominal or lower back pain and haemodynamic instability. There have been case reports of co-existing left testicular pain; however, very few cases describe right testicular pain as the sentinel symptom. We discuss the case of a 75-year-old man who presented to the on-call urologists with a 6-day history of right testicular pain. On examination, a painless AAA was detected. The patient was stable and a CT scan demonstrated a large AAA extending into the right iliac vessels, with suggestion of leakage. Attempted emergency repair was unsuccessful and the patient died in theatre. This atypical presentation of occult aneurysm leak highlights the need for clinical vigilance in the older patient with seemingly benign groin symptoms, including isolated right testicular pain.


1984 ◽  
Vol 01 (3) ◽  
pp. 429-433 ◽  
Author(s):  
Patrick J. O'Hara ◽  
Gregory P. Borkowski ◽  
Norman R. Hertzer ◽  
Peter B. O'Donovan ◽  
Susan L. Brigham ◽  
...  

Author(s):  
Florentina Ene ◽  
Carine Gachon ◽  
Patrick Delassus ◽  
Liam Morris

Abdominal aortic aneurysm (AAA) represents an abnormal dilatation and weakening of the abdominal aorta with high risk of rupture. Most aneurysms of the infrarenal aorta possess an asymmetrical fusiform morphology.


2020 ◽  
Vol 6 (2) ◽  
pp. 221-223
Author(s):  
Caleb Baz Figueroa ◽  
Alejandro Delgado Molinos ◽  
Octavio de la Torre Scherak ◽  
Ángel López Castillo ◽  
Juan Carlos Moy Petersen ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027291
Author(s):  
Wing Cheuk Chan ◽  
Dean Papaconstantinou ◽  
Doone Winnard ◽  
Gary Jackson

ObjectivesTo describe the proportions of people dying from abdominal aortic aneurysm (AAA) who might have benefited from a formal screening programme for AAA.DesignRetrospective cross-sectional review of deaths.Setting and study populationsAll AAA deaths registered in New Zealand from 2010 to 2014 in the absence of a national AAA screening programme.Main outcome measuresKnown history of AAA prior to the acute event leading to AAA death, prognosis limiting comorbidities, history of prior abdominal imaging and a validated multimorbidity measure (M3-index scores).Results1094 AAA deaths were registered in the 5 years between 2010 and 2014 in New Zealand. Prior to the acute AAA event resulting in death, 31.3% of the cohort had a known AAA diagnosis, and 10.9% had a previous AAA procedure. On average, the AAA diagnosis was known 3.7 years prior to death. At least 77% of the people dying from AAA also had one or more other prognosis limiting diagnosis. The hazard of 1-year mortality associated with the non-AAA related comorbidities for the AAA cohort aged 65 or above were 1.5–2.6 times higher than to the age matched general population based on M3-index scores. In 2014, overall AAA deaths accounted for only 0.7% of total deaths, and 1.0% of deaths among men aged 65 or above in New Zealand. At most, 20% of people dying from AAA in New Zealand between 2010 and 2014 might have had the potential to derive full benefit from a screening programme. About 51% of cases would have derived no or very limited benefit from a screening programme.ConclusionFalling AAA mortality, and high prevalence of competing comorbidities and/or prior AAA diagnosis and procedure raises the question about the likely value of a national AAA screening programme in a country such as New Zealand.


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