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Abdominal aortic aneurysms and thoracic aortic atheromas

H R Reynolds1, P A Tunick, S Kort

  • 1Department of Medicine, NYU School of Medicine, 550 First Avenue, New York City, NY 10016, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|November 7, 2001
PubMed

Insights

A strong association exists between abdominal aortic aneurysms (AAA) and thoracic aortic atheromas (ATHs). Screening for AAA in patients with ATHs identified via transesophageal echocardiography (TEE) is recommended to prevent stroke.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Abdominal aortic aneurysm (AAA) is linked to atherosclerosis in other parts of the body.
  • Thoracic aortic atheromas (ATHs), detected via transesophageal echocardiography (TEE), are a significant cause of stroke and peripheral embolization.
  • The relationship between AAA and ATHs requires further investigation to assess screening importance.

Purpose of the Study:

  • To determine the association between abdominal aortic aneurysm (AAA) and thoracic atheromas (ATHs).
  • To evaluate the significance of screening patients with ATHs for AAA.

Main Methods:

  • A retrospective analysis compared 109 patients with AAA and 109 controls for ATH prevalence on TEE and historical variables.
  • A prospective analysis screened 364 patients for AAA via ultrasonography during TEE.

Main Results:

  • ATHs were found in 52% of AAA patients versus 25% of controls (OR=3.3, P=.00003).
  • Multivariate analysis identified ATHs as independently associated with AAA (P=.001).
  • Prospective screening revealed AAA in 13.9% of patients with ATHs versus 1.4% without (P<.0001, OR=11.4).

Conclusions:

  • A significant association exists between abdominal aortic aneurysms and thoracic atheromas.
  • Patients with AAA may face elevated stroke risk due to co-occurring thoracic atheromas.
  • Routine AAA screening is advised for patients with TEE-identified ATHs.
Abstract

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