Annals of vascular surgery · 2025
Prevalence of Isolated Iliac Aneurysm in Patients with Acute Aortic Dissection.
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Li Xinyang, Liu Chong, Wang Chuanjiang, Hu Haidi
Аннотация
BACKGROUND: The relationship between isolated iliac aneurysms (IIAs) and acute aortic dissection (AAD) is uncertain. We aimed to determine the prevalence of IIAs in patients with AAD and evaluate the independent risk factors for the presence of IIAs in them.
METHODS: Seven patients were confirmed to have AAD with IIAs (AAD + IIA group) who had undergone computed tomography angiography (CTA). The control group comprised 597 patients were confirmed with AAD without IIAs (AAD group). Demographic data or baseline characteristics of patients included in this study were completely obtained. Two readers reviewed all CTA scans independently to assess the data of the IIAs. Baseline characteristics were compared between the aortic dissection group and the control group using propensity score matching, and logistic regression analysis was performed to determine the independent risk factors for the presence of IIAs.
RESULTS: The average age was 67.57 ± 10.13 years in the AAD + IIA group and 52.09 ± 12.06 years in the AAD group (P = 0.002). The proportion of smokers was respectively 39.6% and 85.7% in the AAD group and AAD + IIA group (P = 0.037). In the control group, no difference in age was observed between the dissections from the aorta to the iliac artery (n = 251 [42%]; 51.08 ± 11.35 years) and those limited to the aortic region (n = 346 [58%]; 52.82 ± 12.51 years) (P = 0.055). Multivariate analysis revealed age as an independent risk factor for the presence of IIAs (odds ratio, 1.144; 95% confidence interval, 1.059-1.235; P = 0.001). Similarly, smoking was an independent risk factor for the presence of IIAs (odds ratio, 14.601; 95% confidence interval, 1.652-129.073; P = 0.016).
CONCLUSION: The prevalence of IIA in AAD was 1.2%. Age and smoking can increase the prevalence of IIAs in patients with AAD. Our results can represent a valid aid in selecting patients to be screened, which would improve the treatment outcome. Further prospective studies are warranted to demonstrate the substantial prevalence of IIAs in the AAD population.
METHODS: Seven patients were confirmed to have AAD with IIAs (AAD + IIA group) who had undergone computed tomography angiography (CTA). The control group comprised 597 patients were confirmed with AAD without IIAs (AAD group). Demographic data or baseline characteristics of patients included in this study were completely obtained. Two readers reviewed all CTA scans independently to assess the data of the IIAs. Baseline characteristics were compared between the aortic dissection group and the control group using propensity score matching, and logistic regression analysis was performed to determine the independent risk factors for the presence of IIAs.
RESULTS: The average age was 67.57 ± 10.13 years in the AAD + IIA group and 52.09 ± 12.06 years in the AAD group (P = 0.002). The proportion of smokers was respectively 39.6% and 85.7% in the AAD group and AAD + IIA group (P = 0.037). In the control group, no difference in age was observed between the dissections from the aorta to the iliac artery (n = 251 [42%]; 51.08 ± 11.35 years) and those limited to the aortic region (n = 346 [58%]; 52.82 ± 12.51 years) (P = 0.055). Multivariate analysis revealed age as an independent risk factor for the presence of IIAs (odds ratio, 1.144; 95% confidence interval, 1.059-1.235; P = 0.001). Similarly, smoking was an independent risk factor for the presence of IIAs (odds ratio, 14.601; 95% confidence interval, 1.652-129.073; P = 0.016).
CONCLUSION: The prevalence of IIA in AAD was 1.2%. Age and smoking can increase the prevalence of IIAs in patients with AAD. Our results can represent a valid aid in selecting patients to be screened, which would improve the treatment outcome. Further prospective studies are warranted to demonstrate the substantial prevalence of IIAs in the AAD population.