Colour Doppler and grey scale ultrasound features of HIV-related vascular aneurysms

Atypical aneurysms of large elastic arteries owing to human immunodeficiency virus (HIV) vasculopathy are a well described complication of acquired immunodeficiency syndrome (AIDS). However, there are no reports describing the ultrasound features of these lesions. We performed a retrospective review of ultrasound images of 12 patients presenting with 39 HIV-related aneurysms over a 2 year period. Of these there were a total of 12 patients with symptomatic lesions comprising the superficial femoral artery (n=5), the origin of the internal carotid artery (n=3), the popliteal artery (n=2), the common femoral artery (n=1) and the common iliac artery (n=1). The remainder were asymptomatic and were demonstrated radiologically. The ultrasound features of large symptomatic HIV-related femoral and carotid aneurysms were typical of pseudoaneurysms with a defect or "blow-out" in the vessel wall and turbulent pulsatile flow. Of note was the presence of marked thickening of the vessel adjacent to the aneurysm and hyperechoic "spotting" of the arterial wall. These ultrasound features described may be unique to HIV vasculopathy.