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Presentation and patterns of aortic aneurysms in young patients
S C Muluk1, J P Gertler, D C Brewster
1Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston.
Journal of Vascular Surgery
|December 1, 1994
Summary
Younger patients with aortic aneurysms (AA) present with more symptoms and proximal disease. Smoking is a significant factor in early-onset AA, suggesting a distinct at-risk subgroup.
Area of Science:
- Vascular Surgery
- Aortovascular Diseases
- Epidemiology of Aortic Aneurysm
Background:
- Aortic aneurysm (AA) is typically a disease of older individuals.
- Younger patients (<51 years) with AA requiring surgery are less common but present unique clinical challenges.
Purpose of the Study:
- To compare the clinical characteristics of surgically treated young patients with AA to a cohort of older patients.
Main Methods:
- Retrospective analysis of 26 surgically treated patients under 51 years with AA (Group I).
- Comparison with 75 randomly selected surgically treated patients aged 65-75 years (Group II) during 1977-1993.
- Exclusion of dissections, traumatic pseudoaneurysms, and ascending/arch aneurysms.
Main Results:
- Younger patients (Group I) presented with more symptoms (46% vs 6.7%) and larger AA (6.9 cm vs 6.0 cm).
- Definable causes like Takayasu's, Cogan's, and Marfan syndromes were more frequent in young patients (23%).
- Group I showed a higher prevalence of proximal AA (46% vs 18%) and significantly more cigarette smoking (83% vs 51%).
Conclusions:
- Aortic aneurysm in young adults is often symptomatic with more proximal involvement compared to older patients.
- Cigarette smoking appears to be a critical factor in the pathogenesis of early-onset AA.
- These findings suggest a subgroup of patients at risk for early and aggressive aortic aneurysm disease.