Relación entre variaciones anatómicas del cayado de la aorta, aneurismas y disección. Estudio de casos y controles en Hospital de Méderi, Bogotá, Colombia 2010-2021
Thesis
Introduction: Aortic dissection and aneurysm are diseases with low incidence and prevalence. Despite this, they result in high rates of morbidity and mortality, complex procedures that often require long periods of hospitalization in Intensive Care Units, and high costs that impact the healthcare system. Therefore, their prevention and timely diagnosis are fundamental pillars in the field of health. Aortic diseases have a complex etiopathogenesis, and recently, anatomical variations of the aortic arch have been linked to the occurrence of these pathologies. However, the results have been contradictory. Objectives: To determine if there is an association between anatomical variations of the aortic arch and aortic aneurysms and dissections. Methodology: A case-control study was conducted by reviewing all the CT angiography scans of patients treated at the Hospital Universitario Mayor - Méderi between 2010 and 2021. Patients with aortic aneurysm or dissection had their medical records reviewed and were considered as cases, while patients in whom these conditions were ruled out were considered controls. Results: A sample of 562 patients was collected, of which 39.9% had an aneurysm, 9.61% had a dissection, and 14 individuals had ectasia, which were considered as controls, resulting in a total of 284 controls (50.5%). Most men presented aortic pathology (Aneurysm: 66.1%, Dissections: 61.1%), while controls had a higher proportion of women (60.9%). The most frequent type of aortic arch was type I with its three classic branches (77.4%), followed by type II with a frequency of 85 individuals (15.1%), and finally, type III with 4.8%. Twelve cases (2.1%) were found in which no report was found in the existing literature for their classification. Chi-square test and logistic regression were performed, and no statistically significant relationship was found between anatomical variables of the aortic arch and aneurysm or dissection. Discussion: No association was established between aortic aneurysm and dissection and anatomical variations of the aortic arch. However, this does not rule out the relationship between aortic arch variations and aortic pathologies due to the low prevalence found.
