Is Non-specific Aneurysmal Disease of the Infrarenal Aorta Also a Peripheral Microvascular Disease?

Abstract

Objectives to examine whether aneurysmal disease of the aorta has a functional component in the peripheral microÍvasculature. Materials ten normal persons; and 15 patients who had been operated on for ruptured non-specific infrarenal aortic aneurysm months to years previously were studied. Methods blood flow rates were measured: (a) in the subcutaneous adipose tissue of the forefoot by the133xenon local washout method (perfusion through nutritive capillaries supplied by arterioles with elastin in the tunica media); and (b) in the arteriovenous anastomoses of the pulp of the first toe as measured by the heat washout method (perfusion predominantly through thick-walled tubes without elastin). Perfusion rates were measured in supine subjects at heart level, at 30 cm above and at 30 cm below heart level. Results in subcutaneous adipose tissue, the capillary blood flow rate was four times higher in patients with aneurysmal disease than in normal subjects. Both groups exhibited autoregulation of blood flow and a normal veno-arteriolar sympathetic axon reflex. Blood flow rates in the arteriovenous anastomoses of the pulp did not differ between aneurysm patients and normal subjects. Autoregulation and the axon reflex were absent in the arteriovenous anastomoses of normal subjects as well as in aneurysm patients. Conclusions non-specific aneurysmal disease of the infrarenal aorta has a peripheral functional component affecting arterioles but not arteriovenous anastomoses.