Abdominal aneurysms in a black population: clinicopathological study

Area of Science:

• Vascular Surgery
• Epidemiology
• Pathology

Background:

• Aneurysms of the aorta and its abdominal branches are significant vascular conditions.
• Understanding demographic and etiological differences in aneurysm presentation is crucial for effective treatment.

Purpose of the Study:

• To compare the incidence, demographics, and underlying pathologies of abdominal aortic aneurysms between Black and White patients.
• To investigate the etiological factors contributing to aneurysms in different racial groups.

Main Methods:

• Retrospective analysis of 2182 patients treated in a Vascular Service over 3 years, excluding vascular trauma.
• Comparison of aneurysm characteristics, including location, etiology, and patient demographics (age, sex), between Black and White patient cohorts.
• Surgical treatment data and pathological findings were reviewed.

Main Results:

• Abdominal aortic aneurysms were less common in Black patients (4.6%) compared to White patients (29.5%).
• Black patients presented with a more heterogeneous aneurysm pathology, including atherosclerotic and non-atherosclerotic causes (e.g., aorto-arteritis, tuberculous arteritis), while White patients predominantly had atherosclerotic aneurysms.
• Aneurysms in Black patients occurred at a younger mean age (49.4 years) with equal sex distribution, versus White patients (67.1 years) with a 2:1 male-to-female ratio.

Conclusions:

• Abdominal aortic aneurysm is an uncommon disease in Black patients.
• When aneurysms do occur in Black patients, a more diverse range of pathologies should be anticipated, with a notably higher prevalence of aorto-arteritis compared to White patients.
• These findings highlight the importance of considering racial disparities in the etiology and presentation of abdominal aortic aneurysms.