PERIPHERAL ANEURYSMS AND ARTERIOMEGALY - IS THERE A FAMILIAL PATTERN

Purpose: Studies have shown that 11% to 18%;, of patients with an abdo minal aortic aneurysm (AAA) have a first-degree relative with an AAA. A familial pattern among patients with peripheral arterial aneurysms a nd arteriomegaly has not been reported. The objective of this study wa s to examine familial patterns among patients with peripheral arterial aneurysm and arteriomegaly and compare them with patterns among patie nts with AAA. Methods Pedigrees were constructed for first-degree rela tives of patients a ho received the diagnosis of peripheral arterial a neurysm, arteriomegaly, or AAA from 1988 through 1996. The presence of aneurysms and risk factors was confirmed for patients and relatives b y means of telephone interviews and review of hospital and physician r ecords. Results: Seven hundred three first-degree relatives older than 50 years were contacted for 140 probands with peripheral arterial ane urysm, AAA, or arteriomegaly. There were differences in risk factors f or hernia and diabetes mellitus among the probands with peripheral art erial aneurysm, AAA, or arteriomegaly but none for relatives. Patients with peripheral arterial aneurysm (n = 40) had a 10% (4/40) familial incidence rate of an aneurysm, patients with AAA (n = 86) had a 22% (1 9/86) familial incidence rate, and patients with arteriomegaly (n = 14 ) had a 36% (5/14) familial incidence rate. AAA (24/28, or 86%) was th e aneurysm diagnosed most commonly among first-degree relatives. Most aneurysms (85%) occurred among men. Conclusion: There appears to be a gradation of familial patterns from peripheral arterial aneurysm to AA A to arteriomegaly among patients with degenerative aneurysmal disease , and there appears to be a predominance among men. Relatives of patie nts with any of the 3 lesions-peripheral arterial aneurysm, AAA, arter iomegaly-most frequently have AAA. Relatives of patients with AAA, per ipheral arterial aneurysm, or arteriomegaly map be screened by means o f a physical examination for peripheral aneurysmal disease. Screening by means of ultrasound examination of the aorta should be limited to f irst-degree relatives of patients with aortic aneurysms or arteriomega ly.