Infrarenal versus Suprarenal Abdominal Aortic Aneurysms: Comparison of Associated Aneurysms and Renal Artery Stenosis

Abstract

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 73.0years, 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.