True juxta-anastomotic aneurysms in the residual infra-renal abdominal aorta.
BACKGROUND
abdominal aortic dilatation can occur above the graft following repair of infra-renal abdominal aortic aneurysm (AAA). This study aimed to determine the incidence and possible aetiological associations of recurrent juxta-anastomotic aneurysms following open repair of AAA.


METHODS
the diameter of the infra-renal aorta above the graft of 135 patients who had previously undergone open AAA repair was determined using ultrasound. In those where the diameter was greater than 40 mm a CT scan was undertaken. Co-morbid and operative details were determined from the patients and their clinical notes.


RESULTS
seven patients had true juxta-anastomotic aneurysms (>40 mm) in the residual infra-renal abdominal aorta, the occurrence of which was associated with tobacco smoking and hypertension. There was no association with other co-morbid factors, surgical operative details or the development of iliac aneurysms (which occurred in 3% of patients).


CONCLUSIONS
true juxta-anastomotic aneurysms develop in the residual infra-renal neck of patients following open repair of abdominal aortic aneurysm. Tobacco smoking and hypertension are significant factors associated with the development of these aneurysms. This group of patients may warrant surveillance to prevent aneurysm rupture.
Baker
D M
DM
Department of Vascular and Endovascular Surgery, E Floor, West Block, University Hospital, Derby Road, Nottingham NG7 2UH, UK.
Hinchliffe
R J
RJ
Yusuf
S W
SW
Whitaker
S C
SC
Hopkinson
B R
BR
D000368:Aged; D000714:Anastomosis, Surgical; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed