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Updated: Feb 5, 2026
Porcine Model of Infrarenal Abdominal Aortic Aneurysm
Published on: November 21, 2019
Coexistence and management of abdominal aortic aneurysm and coronary artery disease
Mateusz K Hołda1, Paweł Iwaszczuk2, Karolina Wszołek2
1Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College. mkh@onet.eu.
Insights
Patients with abdominal aortic aneurysm (AAA) and coronary artery disease (CAD) often have significant coronary stenosis. Early coronary evaluation before AAA repair may improve outcomes and reduce complications.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Abdominal aortic aneurysm (AAA) and coronary artery disease (CAD) share common risk factors.
- Management of patients with coexisting AAA and CAD presents unique challenges.
Purpose of the Study:
- To evaluate the management experience of patients with concurrent AAA and CAD.
- To determine the predictors and outcomes of coronary artery evaluation in patients undergoing AAA repair.
Main Methods:
- Retrospective review of 271 patients undergoing elective AAA repair.
- Coronary imaging analysis in 118 patients to assess for CAD.
- Subgroup analysis to identify predictors of significant coronary stenosis.
Main Results:
- Significant coronary stenosis (>70%) was found in 65.3% of patients.
- Prior percutaneous coronary intervention (PCI) and older age predicted significant stenosis.
- Early coronary evaluation before AAA repair was associated with shorter hospitalization and reduced major adverse cardiovascular events.
Conclusions:
- A significant proportion of patients with AAA have concomitant CAD requiring evaluation.
- An early coronary artery evaluation strategy may benefit patients with AAA.
- Proactive management of CAD in AAA patients can improve clinical outcomes.
Background:
Abdominal aortic aneurysm (AAA) and coronary atherosclerosis share common risk factors. In this study, a single-center management experience of patients with a coexistence of AAA and coronary artery disease (CAD) is presented.
Methods:
271 consecutive patients who underwent elective AAA repair were reviewed. Coronary imaging in 118 patients was considered suitable for exploration of AAA coexistence with CAD.
Results:
Significant coronary stenosis (> 70%) were found in 65.3% of patients. History of cardiac revascularization was present in 26.3% of patients, myocardial infarction (MI) in 31.4%, and 39.8% had both. In a subgroup analysis, prior history of percutaneous coronary intervention (PCI) (OR = 6.9, 95% CI 2.6-18.2, p < 0.001) and patients' age (OR = 1.1, 95% CI 1.0-1.2, p = 0.007) were independent predictors of significant coronary stenosis. Only 52.0% (40/77) of patients with significant coronary stenosis underwent immediate coronary revascularization prior to aneurysm repair: PCI in 32 cases (4 drug-eluting stents and 27 bare metal stents), coronary artery bypass graft in 8 cases. Patients undergoing revascularization prior to surgery had longer mean time from coronary imaging to AAA repair (123.6 vs. 58.1 days, p < 0.001). Patients undergoing coronary artery evaluation prior to AAA repair had shorter median hospitalization (7 [2-70] vs. 7 [3-181] days, p = 0.007) and intensive care unit stay (1 [0-9] vs. 1 [0-70] days, p = 0.014) and also had a lower rate of major adverse cardiovascular events or multiple organ failure (0% vs. 3.9%, p = 0.035). A total of 11.0% of patients had coronary artery aneurysms.
Conclusions:
Patients with AAA might benefit from an early coronary artery evaluation strategy.
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