Is non-specific aneurysmal disease of the infrarenal aorta also a peripheral microvascular disease?

Objectives: to examine whether aneurysmal disease of the aorta has a functi onal component in the peripheral micro-vasculature. Materials: ten normal persons; and 15 patients who had been operated on for ruptured non-specific infrarenal aortic aneurysm months to years previousl y were studied. Methods: blood flow rates were measured: (a) in the subcutaneous adipose ti ssue of the forefoot by the (133)xanon local washout method (perfusion thro ugh nutritive capillaries supplied by arterioles with elastin in the tunica media); and (b) in the arteriovenous anastomoses of the pulp of the first toe as measured by the heat washout method (perfusion predominantly through thick-walled tubes without elastin). Perfusion rates were measured in supi ne subjects at heart level, at 30 cm above and at 30 cm below heart level. Results: in subcutaneous adipose tissue, the capillary blood flow rate was four times higher in patients with aneurysmal disease than in normal subjec ts. Both groups exhibited autoregulation of blood flow and a normal veno-ar teriolar sympathetic axon reflex. Blood flow rates in the arteriovenous ana stomoses of the pulp did not differ between aneurysm patients and normal su bjects. Autoregulation and the axon reflex were absent in the arteriovenous anastomoses of normal subjects as well as in aneurysm patients. Conclusions: non-specific aneurysmal disease of the infrarenal aorta has a peripheral functional component affecting arterioles but not anastomoses.