Influence of Aortic Deviation on Abdominal Aorta Bifurcation Level Relative to Vertebral Position

Abstract

Introduction Research on abdominal aortic deviation (AAD) and its impact on the vertebral level of abdominal aortic bifurcation (AAB) has been limited. We aimed to determine the level of AAB with respect to vertebral levels and assess the proportion of AAD and its impact on AAB. Materials and methods This single-arm, cross-sectional, retrospective study involved contrast-enhanced computed tomography (CECT) scans of the abdomen and pelvis of 208 subjects aged 18 years or older. AAD and AAB in terms of vertebral levels were noted using the digital imaging and communication in medicine (DICOM) viewing software RadiAnt (Medixant, Poznań, Poland). Results The rate of AAD was found to be 44 out of 208 (21.2%), 16 out of 98 (16.3%) in men and 28 out of 110 (25.45%) in women (p=0.10). The AAD rates in the 31-40-, 51-60-, and 71-80-year age groups were 11 out of 37 (29.7%), 17 out of 61 (27.8%), and three out of seven (42.8%) with p=0.03, respectively. AAB was seen in the middle of the L4 vertebrae in 65 cases (31.2%), followed by 49 cases (23.6%) in the L4 lower vertebrae. Twenty-three (20.9%) women had AAB above the L4, compared to 13 (13.2%) men (p=0.34). AAB was located below the L4 vertebral level in eight out of 44 (18.18%) subjects with AAD versus 41 out of 164 (25%) subjects without AAD (p=0.55). Conclusion AAD was observed in approximately one-fifth of the subjects in our study cohort, with a higher proportion among women and in elderly age groups. AAB was most commonly observed in the middle of the L4 vertebrae and AAD did not impact AAB levels.