Abdominal duplex ultrasound screening for occult aortic aneurysm during carotid arterial evaluation

The purpose of this study was to investigate the use of a modified abdominal ultrasound examination, which was performed at the time of routine diagnostic carotid artery duplex evaluation, to identify patients at risk for aortic aneurysms.

A prospective study was undertaken that consisted of a limited ultrasound examination of the abdominal aorta on patients referred to our facilities for duplex carotid evaluation. One hundred thirty-one patients were included in the study; 52% were men and 48% were women, who ranged in age between 40 to 93 years. These patients were not known or suspected to have an abdominal aortic aneurysm.

Eleven infrarenal aortic aneurysms (8.4%) were detected, four in patients with positive carotid studies (11%) and seven in those with negative studies (7%); size ranged from 3.0 to 7.5 cm. Categoric data analysis did not produce significance, but a stepwise regression and discriminant analysis model revealed a significant relationship between abnormal velocities and occlusive changes in the carotid arteries and the presence of aortic aneurysms.

Hemodynamically significant carotid artery disease, as diagnosed by duplex examination, appears to be a definite marker for an increased incidence of abdominal aortic aneurysm when compared with the general population. When selective abdominal aortic ultrasonography is done in conjunction with the carotid study, the requirements of additional equipment and technologist time are modest, and the potential benefit to the patient may be significant.