Anatomical analysis of the abdominal aorta in a South African sample: influence of age and sex.

Purpose: The anatomy of the abdominal aorta (AA) varies with age and sex; however, limited studies exist from South Africa. Given the increased incidence of endovascular treatment of the AA, reference values are relevant for interventionalists for improving the safety of endovascular procedures. Therefore, the study aimed to determine the lengths, diameters and tortuosity of the AA and their association with age and sex in a South African sample.

Methods: After ethical approval, 97 computed tomography angiography (CTA) scans from an adult sample (54 male and 43 female), mean age 48.5 ± 17.2 years were analysed. The aortic length was measured from the origin of the coeliac trunk to the bifurcation point of the AA. The lumen diameters of the aorta were measured at three landmarks. Tortuosity of the AA was quantified with the tortuosity index and its prevalence was determined.

Results: The AA was longer in males and showed a significant weak positive correlation with age. The mean diameters of the AA were larger in males and had a significant strong positive correlation with age in both sexes (p < .001). There was a strong positive correlation between age and tortuosity in both sexes (p < .001). The prevalence of a tortuous c-shaped-curve phenotype was 8.2%, with a 7:1 male-to-female ratio.

Conclusion: The dimensions and tortuosity differed between sexes and varied significantly with age. These findings may contribute towards reference values in the South African setting, inform patient selection and complement decision-making of endovascular treatment strategies.