Pattern of Extracranial Peripheral Aneurysm at a Referral Hospital in Kenya

Abstract

Peripheral aneurysms are important because of concurrence with aortic ones and potential to thromboembolise or rapture. Their distribution shows population variations yet reports from Africa are scarce and altogether absent from Kenya. Objective To describe the pattern of peripheral aneurysms in a Kenyan national referral hospital. Patients and methods Records of in-patients with a diagnosis of peripheral aneurysms at Kenyatta National Hospital between January 1998 and December 2007 were analyzed for presentation, diagnostic method, risk factors, site, age and gender distribution. Only records containing all these data were included. Data were analyzed using SPSS version 13.0 and presented using tables, and bar charts. Results Ninety six cases involved the femoral (24%), common carotid (15.6%); brachial (12.5%); brachiocephalic (11.5%) and popliteal (10.4%) arteries. They presented with pulsatile mass (37.5%), painful swelling (22.9%) and pressure on subjacent structures (13.5%). Diagnosis was confirmed by Doppler ultrasound (37.5%), conventional angiography (30.2%) and plain ultrasound (14.6%). Mean age was 45.6 years (range 13 – 79 years); with 50% of them occurring in individuals aged 40 years and younger. Common risk factors were trauma (39.6%), hypertension (13.5%) and atherosclerosis (9.4%). Male:female ratio was: 15:1 for femoropopliteal, 5:1 for brachial; 1:1 for common carotid and 1:2.6 for brachiocephalic trunk. Conclusion Characteristics of peripheral aneurysms in the Kenyan study population vary from those of Caucasians. They are more widespread, trauma related, and occur in younger individuals. Prudent management of risk factors is recommended.