Detection of abdominal aortic aneurysm in patients with peripheral artery disease

To describe the prevalence of abdominal aortic aneurysms (AAA) in patients with peripheral artery disease (PAD).

Observational, descriptive, transverse study.

We performed an abdominal ultrasound in 1190 consecutive patients with lower limb chronic ischemia (1/99-12/04). We registered cardiovascular risk factors and clinical data for analysis.

The ultrasound was inconclusive in 24 (2%) patients; 1166 patients completed the study. They were mostly male (93.7%), with an age mean of 67+/-9.9 years (37.7-93.4). The main cardiovascular risk factors were: smoking (80.9%), hypertension (41.7%) and hypercholesterolemia (31.4%). The prevalence of AAA was 13% (n = 151). Only 1.5% (n = 17) of the patients had a large AAA (>5 cm). The AAA was clearly more prevalent in men (n = 148; 13.6%) than in women (n = 3; 4.1%) (RR 3.47; 95% CI 1.11-10.89; p = 0.02). The prevalence significantly increased with age, with a maximum of 17.1% in over 75-year-old men (p = 0.006). Patients with tibial disease had a significantly higher prevalence of AAA than aortoiliac or femoro-popliteal disease (p = 0.02).

The prevalence of AAA in patients with PAD is much higher than that reported in the general population. We recommend that an abdominal ultrasound be routinely included in the study of these patients. Over 75-year-old men are at particularly high-risk.