Chronic abdominal aortic occlusive disease related to antiphospholipid syndrome: a rare presentation

Hui Jiang1, Yu Shi1, Wei Liu2

  • 1Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science & Technology; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.

RMD Open
|January 4, 2024
PubMed

Insights

Chronic abdominal aortic occlusive disease (CAAOD) is a rare manifestation of antiphospholipid syndrome (APS). Smoking and hyperhomocysteinaemia are key risk factors in aPL-positive patients with CAAOD, necessitating early diagnosis and management.

Area of Science:

  • Vascular Medicine
  • Rheumatology
  • Cardiology

Background:

  • Chronic abdominal aortic occlusive disease (CAAOD) is an infrequent complication of antiphospholipid syndrome (APS).
  • Antiphospholipid antibodies (aPL) are associated with arterial and venous thrombosis.
  • Understanding CAAOD in aPL-positive individuals is crucial for cardiovascular health and peripheral circulation management.

Purpose of the Study:

  • To investigate the clinical and radiological characteristics of CAAOD in patients with antiphospholipid antibodies (aPL).
  • To identify risk factors associated with CAAOD in aPL-positive patients.
  • To provide insights into the management of CAAOD within the context of APS.

Main Methods:

  • A case-control study comparing aPL-positive patients with CAAOD and non-CAAOD arterial thrombotic events.
  • Analysis of clinical features, radiological images, and patient outcomes from 2013 to 2021.
  • Inclusion of 114 patients who experienced arterial events.

Main Results:

  • Twelve patients were diagnosed with abdominal aortic stenosis or occlusion (CAAOD).
  • The CAAOD group showed significantly higher rates of critical smoking habits (66.67%) and hyperhomocysteinaemia (66.67%) compared to the non-CAAOD group.
  • Radiological findings revealed long-segment infrarenal aorta stenosis, sometimes involving renal and common iliac arteries, with lesions ranging from stenosis to total occlusion.

Conclusions:

  • CAAOD is a rare but significant manifestation in aPL-positive patients.
  • Smoking and hyperhomocysteinaemia are identified as critical risk factors for CAAOD in this population.
  • Early diagnosis and comprehensive management, including interventions and anticoagulation, are emphasized for better outcomes.
Abstract