Higher prevalence of abdominal aortic aneurysms in patients with carotid stenosis but without diabetes

Background. We compared abdominal aortic aneurysm (AAA) prevalence in 3 gro ups of patients at the Hines Veterans Affairs Medical Center: (1) patients with 50 % or more carotid stenosis, (2) patients with less than 50 % stenos is, and (3) patients screened for the Aneurysm Detection and Management Methods. Of all the patients referred to the vascular laboratory for caroti d duplex examination during a 12-month period patients with 50 % or more ca rotid stenosis underwent ultrasonography of the abdominal aorta unless they had a previous scan or previous aortic surgery (group 1, n = 374). Patient s with less than 50 % carotid stenosis who had been screened for ADAM compr ised group 2 (n = 139). They were compared with all patients screened for A DAM at our center during the same time period (group 3, n = 2477). Results. AAA of 3.0 cm or mom were present in 18.2 %, 12.2 %, and 7.2 % of groups 1, 2 and 3, respectively; AAA of 4.0 cm or more were present in 8.3 %, 5.8 %, and 2.1 % of groups 1, 2 and 3, respectively. Among patients with carotid stenosis, those patients without diabetes accounted for the observ ed increase in prevalence (21.9 % greater than or equal to 3.0 cm and 10.2 % greater than or equal to 4.0 cm vs 9.2 % and 2.8 % in patients with diabe tes). Conclusions. The relative risk of AAA is 2 to 3 times greater in patients w ith carotid stenosis compared with patients undergoing routine screening: H owever, only patients without diabetes account for the increased prevalence . Selective AAA screening of patients who are not diabetic with carotid ste nosis is recommended.