Abstract

LEMOS, Mariana; SILVA, Ivone  and  ALMEIDA, Rui. Multiple Aneurysmal Disease: a review. Angiol Cir Vasc [online]. 2019, vol.15, n.2, pp.97-112. ISSN 1646-706X.

Introduction: The degeneration of arterial aneurysms is a common manifestation of atherosclerosis, a process that involves the arterial vasculature, occurring in several arterial territories. With the increase of life expectancy, the number of patients with arterial aneurysms has increased, since its prevalence raises with age. Society of Vascular Surgery classifies arterial aneurysms according to their etiology. The most common form is the degenerative aneurysm, which can result from arterial wall degeneration due to several factors - genetic, inflammatory and/or environmental. Multiple aneurysms are more common in patients with arterial aneurysms of the lower limbs, especially in the popliteal artery. A relationship between abdominal aortic aneurysms and lower extremities aneurysms will be discussed in this review. Objectives: The purpose of this review is to report what’s new concerning causes, epidemiology and diagnosis of the multiple aneurysmal disease of the abdominal aorta and the lower extremities’ arteries. Methods: An initial search was conducted in PubMed that gathered 1430 articles, written in English and Portuguese, within a time period from 1960 to 2019. The articles were, firstly, selected on the basis of title and abstract, excluding criteria were non-English papers and single case reports, articles that focused on intra-oor that did not cover the main topics of this review. A definitive selection of 50 articles was based on full text evolution of the report. Development: Multiple aneurysmal disease is rare and affects mainly the male sex. Multiple arterial aneurysms manifest as a systemic vascular disease and have been associated with multiple disorders. Atherosclerosis, vasculitis (polyarteritis nodosa and Behçet’s disease), infectious mycotic aneurysms and hereditary conditions, such as Marfan’s syndrome and Ehlers-Danlos are some of the most involved. The incidence of femoral and popliteal aneurysms in persons with abdominal aortic aneurysms appears higher than that noted previously. Ultrasound scanning is appropriate to the recognition of these peripheral aneurysms among patients with abdominal aortic disease. Because the complications can be serious, the early diagnosis assumes great importance for the prevention of complications associated with great morbidity. The role and the challenges associated with genetic tests to determine susceptibility for multiple aneurysmal disease are discussed in this review. Conclusion: In most cases of multiple aneurysmal disease, symptomatology is vague. Multiple arteries should be surveyed when an aneurysm is suspected or detected at one site, especially in patients with cardiovascular risk factors and in those who present with an isolated aneurysm in the lower extremities.

Keywords : Multiple Aneurysms; Arterial; Etiology; Diagnosis; Treatment.

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