FAMILIAL INCIDENCE OF ABDOMINAL AORTIC-ANEURYSMS

The rupture of an abdominal aortic aneurysms (AAAs) is associated with a mortality rate exceeding 50%. To reduce this figure it is necessary to increase the frequency of early diagnosis and elective surgery. Sc reening the general population for occult AAAs has proven cost ineffec tive. Only by identifying high-risk subgroups will screening programs be improved. The aim of this report was to investigate by ultrasonogra phy the prevalence of previously unknown aortic dilatations among firs t-degree relatives (parents, siblings, and children) of patients opera ted on for AAAs. Ninety-one (52.6%) of the 173 living first degree-rel atives of 51 patients who underwent AAA resection were submitted to an aortoiliac ultrasonographic examination to establish aortic diameter and morphology. There was at least 1 first-degree relative with an AAA (multiplex family) in 10 families (19.6%) before ultrasound screening . With ultrasound a previously unknown infrarenal aortic dilatation wa s detected in 14 subjects (9 men/5 women; 10 siblings and 4 children) of 12 different families. Specifically, these aortic dilatations consi sted of 10 AAAs (diameters ranged from 2.6 to 4.3 cm) and 4 aortic ble bs. These occult aortic dilatations were located in 50% of cases in th e lower third of the infrarenal abdominal aorta. The cumulative incide nce of multiplex families was 35.3%. This study suggests a familial te ndency to have an important etiologic role in the formation of AAAs. F amily screening of, above all, male siblings older than forty-five yea rs will help identify occult AAAs and reduce the mortality rates assoc iated with their rupture.