Jornal Vascular Brasileiro
Jornal Vascular Brasileiro
Original Article

Sexo e idade e sua influência sobre a anatomia da aorta abdominal e seus ramos

Age and sex and their influence on the anatomy of the abdominal aorta and its branches

Adenauer Marinho de Oliveira Góes Junior; Flávia Beatriz Araújo de Albuquerque; Fernanda Acatauassú Beckmann; Fernanda Vieira Centeno; Mariseth Carvalho de Andrade; Waldonio de Brito Vieira

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Resumo: Contexto: Não se sabe ao certo como a idade e o sexo do paciente influenciam na anatomia da aorta abdominal e de seus ramos.

Objetivos: Determinar os padrões anatômicos (diâmetro e angulações) mais frequentes da aorta abdominal e de seus ramos e a influência do sexo e da idade dos pacientes sobre esses padrões.

Métodos: Foram avaliadas tomografias computadorizadas de abdome com contraste endovenoso de 157 pacientes. Foram aferidos calibre e angulação de artérias abdominais em indivíduos de ambos os sexos, agrupados em cinco faixas etárias: 20 a 30 anos, 31 a 40 anos, 41 a 50 anos, 51 a 60 anos e 61 a 70 anos. Foram analisadas 18 variáveis: seis ângulos de emergências arteriais, nove diâmetros arteriais, taxas de dilatação, sexo e faixa etária. Para a obtenção das medidas, utilizou-se o programa de computador RadiAnt 4.2.1 DICOM viewer (Medixant, Poznan, Polônia).

Resultados: Entre as 157 tomografias, 69 eram de homens e 88, de mulheres. Apresentaram diferença estatística (p < 0,05): ângulo de origem e diâmetro da artéria mesentérica superior; ângulo e diâmetro das artérias renais; diâmetro das artérias ilíacas comuns; diâmetro e taxa de dilatação em diversos segmentos da aorta, exceto na porção proximal ao tronco celíaco.

Conclusões: Os diâmetros da aorta (em diversos segmentos) e de seus ramos (exceto da artéria renal esquerda) aumentam progressivamente com o passar da idade em ambos os sexos e são maiores e possuem taxa de dilatação mais elevada em homens do que em mulheres da mesma faixa etária. Entre os sexos, o ângulo de emergência da artéria mesentérica superior foi maior em homens, exceto entre 20 e 30 anos; o ângulo de origem da artéria renal esquerda foi maior em mulheres entre 51 e 60 anos.


envelhecimento, remodelação, tomografia, anatomia, artérias


Background: It is not clear how patients’ age and sex influence the anatomy of the aorta and its branches. Objectives: To determine the most frequent anatomical patterns of diameter and angulation of the abdominal aorta and its branches and the influence of patients’ sex and age on these patterns. Methods: CT scans with intravenous contrast from 157 patients were analyzed. Diameter and angulations of the abdominal aorta and its branches were measured in individuals of both sexes, classified into five age groups: 20 to 30 years, 31 to 40 years, 41 to 50 years, 51 to 60 years, and 61 to 70 years. Eighteen variables were analyzed: 6 arterial origin angles, 9 arterial diameters, rate of diameter enlargement, and patient’s sex and age. RadiAnt 4.2.1 DICOM viewer software was used for measurements. Results: The total of 157 CT scans were from 69 men and 88 women. There were statistical differences (p <0.05) in the following results: angle of origin and diameter of the superior mesenteric artery; renal artery angle and diameter; diameter of the common iliac arteries, and diameter and rate of diameter enlargement of the aorta in several segments, but not the segment immediately proximal to the celiac trunk. Conclusions: The diameters of several aorta segments and of its branches (except the left renal artery) increase progressively with age in both sexes and are larger and have a higher rate of diameter enlargement in men than in women in the same age ranges. Between sexes, the angle of origin of the superior mesenteric artery was larger in men, except between 20 and 30 years, and the angle of origin of the left renal artery was larger in women between 51 and 60 years old.


aging; remodeling; tomography; anatomy; arteries.


1 Majernik J, Szerdiova L. Preparation of medical students for cadaveric anatomy using multimedia education tools. In: Proceedings of the International Conference on Information and Digital Technologies (IDT); 2017; Zilina, Slovakia. New York: IEEE; 2017. p. 252-5.

2 Estai M, Bunt S. Best teaching practices in anatomy education: a critical review. Ann Anat. 2016;208:151-7. PMid:26996541.

3 Bock A, Modabber A, Hölzle F, Prescher A, Classen-Linke I. Improvement of anatomical knowledge and surgical skills in head and neck region: an interdisciplinary hands-on course for clinical students. Ann Anat. 2019;224:97-101. PMid:30998972.

4 Sheikh AH, Barry DS, Gutierrez H, Cryan JF, O’Keeffe GW. Cadaveric anatomy in the future of medical education: What is the surgeons view? Anat Sci Educ. 2016;9(2):203-8. PMid:26213365.

5 Mikael LRP, Gomes AMG, Sousa MM, et al. Envelhecimento vascular e rigidez arterial. Arq Bras Cardiol. 2017;109(3):253-8. PMid:28678931.

6 Han S, Aydin MM, Akansel S, et al. Age-and sex-dependent alteration of functions and epigenetic modifications of vessel and endothelium related biomarkers. Turk J Biol. 2018;42(4):286-96. PMid:30814892.

7 Ferruzzi J, Madziva D, Caulk AW, Tellides G, Humphrey JD. Compromised mechanical homeostasis in arterial aging and associated cardiovascular consequences. Biomech Model Mechanobiol. 2018;17(5):1281-95. PMid:29754316.

8 Costa-Fraga FP, Goncalves GK, Souza-Neto FP, et al. Age-related changes in vascular responses to angiotensin-(1-7) in female mice. J Renin Angiotensin Aldosterone Syst. 2018;19(3):1-10. PMid:30024321.

9 Ogola BO, Zimmerman MA, Clark GL, et al. New insights into arterial stiffening: does sex matter? Am J Physiol Heart Circ Physiol. 2018;315(5):H1073-87. PMid:30028199.

10 Ungvari Z, Tarantini S, Donato AJ, Galvan V, Csiszar A. Mechanisms of vascular aging. Circ Res. 2018;123(7):849-67. PMid:30355080.

11 Foote K, Bennett MR. Molecular insights into vascular aging. Aging. 2018;10(12):3647-9. PMid:30521484.

12 Costantino S, Paneni F, Cosentino F. Ageing, metabolism and cardiovascular disease. J Physiol. 2016;594(8):2061-73. PMid:26391109.

13 Tawfik AM, Sobh DM, Gadelhak B, Sobh HM, Batouty NM. The effect of age and gender on tortuosity of the descending thoracic Aorta. Eur J Radiol. 2019;110:54-9. PMid:30599873.

14 Adji A, O’Rourke MF, Namasivayam M. Arterial stiffness, its assessment, prognostic value, and implications for treatment. Am J Hypertens. 2011;24 (1):5-17. PMid:20940710.

15 Terentes-Printzios D, Vlachopoulos C, Xaplanteris P, et al. Cardiovascular risk factors accelerate progression of vascular aging in the general population: results from the CRAVE study (Cardiovascular Risk Factors Affecting Vascular Age). Hypertension. 2017;70(5):1057-64. PMid:28923899.

16 Qazi S, Massaro JM, Chuang ML, D’Agostino RB, Hoffmann U, O’Donnell CJ. Increased aortic diameters on multidetector CT scan are independent predictors of incident adverse cardiovascular events: the framingham heart study. Circ Cardiovasc Imaging. 2017;10(12):e006776. PMid:29222122.

17 Adriaans BP, Heuts S, Gerretsen S, et al. Aortic elongation part I: The normal aortic ageing process. Heart. 2018;104(21):1772-7. PMid:29593078.

18 Kamenskiy A, Miserlis D, Adamson P, et al. Patient demographics and cardiovascular risk factors differentially influence geometric remodeling of the aorta compared with the peripheral arteries. Surgery. 2015;158(6):1617-27.

19 Rylski B, Desjardins B, Moser W, Bavaria JE, Milewski RK. Gender-related changes in aortic geometry throughout life. Eur J Cardiothorac Surg. 2014;45(5):805-11. PMid:24431164.

20 Gameraddin M. Normal abdominal aorta diameter on abdominal sonography in healthy asymptomatic adults: impact of age and gender. J Radiation Research and Applied Sciences. 2019;12(1):186-91.

21 Bannazadeh M, Jenkins C, Forsyth A, et al. Outcomes for concomitant common iliac artery aneurysms after endovascular abdominal aortic aneurysm repair. J Vasc Surg. 2017;66(5):1390-7. PMid:28697942.

22 Eikendal ALM, Bots ML, Haaring C, et al. Reference values for cardiac and aortic magnetic resonance imaging in healthy, young caucasian adults. PLoS One. 2016;11(10):e0164480. PMid:27732640.

23 Persson PB. The multiple functions of the endothelium: more than just wallpaper. Acta Physiol (Oxf). 2015;213(4):747-9. PMid:25683245.

24 Pagan LU, Gomes MJ, Okoshi MP. Endothelial function and physical exercise. Arq Bras Cardiol. 2018;111(4):540-2. PMid:30365677.

25 Virmani R, Avolio AP, Mergner WJ, et al. Effect of aging on aortic morphology in populations with high and low prevalence of hypertension and atherosclerosis: comparison between occidental and Chinese communities. Am J Pathol. 1991;139(5):1119-29. PMid:1951629.

26 Benetos A, Laurent S, Hoeks AP, Boutouyrie PH, Safar ME. Arterial alterations with aging and high blood pressure: a noninvasive study of carotid and femoral arteries. Arterioscler Thromb. 1993;13(1):90-7. PMid:8422344.

27 Huang Y, Gloviczki P, Duncan AA, et al. Common iliac artery aneurysm: Expansion rate and results of open surgical and endovascular repair. J Vasc Surg. 2008;47(6):1203-10. PMid:18514838.

28 Brunkwall J, Hauksson H, Bengtsson H, Bergqvist D, Takolander R, Bergentz SE. Solitary aneurysms of the iliac arterial system: an estimate of their frequency of occurrence. J Vasc Surg. 1989;10(4):381-4. PMid:2795762.

29 Armon MP, Wenham PW, Whitaker SC, Gregson RHS, Hopkinson BR. Common iliac artery aneurysms in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 1998;15(3):255-7. PMid:9587341.

30 Zommorodi S, Leander K, Roy J, Steuer J, Hultgren R. Understanding abdominal aortic aneurysm epidemiology: Socioeconomic position affects outcome. J Epidemiol Community Health. 2018;72(10):904-10. PMid:29967003.

31 Grimshaw GM, Thompson JM. Changes in diameter of the abdominal aorta with age: an epidemiological study. J Clin Ultrasound. 1997;25(1):7-13.<7::AID-JCU2>3.0.CO;2-M. PMid:9010802.

32 Raaz U, Zöllner AM, Schellinger IN, et al. Segmental aortic stiffening contributes to experimental abdominal aortic aneurysm development. Circulation. 2015;131(20):1783-95. PMid:25904646.

33 Kuivaniemi H, Ryer EJ, Elmore JR, Tromp G. Understanding the pathogenesis of abdominal aortic aneurysms. Expert Rev Cardiovasc Ther. 2015;13(9):975-87. PMid:26308600.

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5fcf78870e882566544ac228 jvb Articles

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