Prevalence of isolated iliac aneurysm in patients with acute aortic dissection: a five-year clinical retrospective study

Abstract

Abstract Background The relationship between isolated iliac aneurysms (IIAs) and acute aortic dissection (AAD) is uncertain. We aimed to determine the prevalence of IIAs in patients with AAD and evaluate the independent risk factors for the presence of IIAs in them. Methods The aortic dissection group comprised seven patients with confirmed AAD and IIAs (AAD + IIA group) who had undergone computed tomography angiography (CTA). The control group comprised 597 patients with confirmed AAD without IIAs (AAD group). Basic clinical information of patients included in this study were completely obtained. Two readers reviewed all CTA scans independently to assess the data of the IIAs. Baseline characteristics were compared between the aortic dissection group and the control group using propensity score matching, and logistic regression analysis was performed to determine the independent risk factors for the presence of IIAs. Results The average patient age was 67.57 ± 10.13 years in the AAD + IIA group and 52.09 ± 12.06 years in the AAD group (P = 0.002). The proportion of smokers was respectively 85.7% and 39.6% in the AAD group and AAD + IIA group (P = 0.037). In the control group, no difference in age was observed between the dissections from the aorta to the iliac artery (n = 251 [42%]; 51.08 ± 11.35 years) and those limited to the aortic region (n = 346 [58%]; 52.82 ± 12.51 years) (P = 0.055). Multivariate analysis revealed age as an independent risk factor for the presence of IIAs (odds ratio, 1.144; 95% confidence interval, 1.059–1.235; P = 0.001). Similarly, smoking was an independent risk factor for the presence of IIAs (odds ratio, 14.601; 95% confidence interval, 1.601–129.073; P = 0.016). Conclusions The prevalence of IIA in AAD was 1.2%. Age and smoking can increase the prevalence of IIAs in patients with AAD. Further prospective studies are warranted to demonstrate the substantial prevalence of IIAs in the AAD population.