Aortic bifurcation angle as an independent risk factor for aortoiliac occlusive disease

Recently, there has been interest in potential geometric risk factors that might result in or exaggerate atherosclerosis. The aortic bifurcation is a complex anatomical area dividing the high pressure blood of the descending abdominal aorta into the lower limbs and pelvis. The distribution of the bifurcation angle and any asymmetry, its relation with age and its possible contribution to the risk of aortoiliac atherosclerosis are presented here. Statistical analysis was performed by SPSS version 11.0 using, Fisher;s exact test, the Pearson and Spearman correlation tests and logistic regression analysis. The p value was set at 0.05. No correlations were found between age, bifurcation angle and angle asymmetry in the Pearson test (p > 0.05). Logistic regression analysis revealed that the bifurcation angle, but not its asymmetry, gender or age, was a significant and independent risk factor for aortoiliac atherosclerosis (model r(2) = 0.662, p = 0.027). With additional study these results may have implications regarding risk factors for aortoiliac atherosclerosis. To our knowledge, this study is the first of its kind to indicate the potential of such an important geometric risk factor for atherosclerosis at the aortic bifurcation.