Background: To investigate the geometry of the aortoiliac (AI) segment and its correlation
with sex, age, and cardiovascular (CV) risk factors. Methods: Abdominal and pelvic
CTA/MRA scans of 204 subjects (120 males; median age: 53 [IQR, 27–75] years) without
AI steno-occlusive disease or scoliosis were retrospectively analyzed. The participants
were enrolled consecutively, ensuring the representation of each age decade. An in-house
written software was developed to assess AI elongation using the tortuosity index
(TI) and absolute average curvature (AAC). Aortic bifurcation angle, common iliac
artery (CIA) take-off and planarity angles, bifurcation asymmetry, and deviation from
optimal bifurcation were calculated and evaluated. Demographic data, CV risk factors,
and medical history were collected from electronic health records. Results: The elongation
of the iliac arteries was more pronounced in males (TI: left CIA, p = 0.011; left
EIA, p < 0.001; right CIA, p = 0.023; right EIA, p < 0.001; AAC: left EIA, p < 0.001;
right EIA, p = 0.001). Age significantly influenced TI and AAC in all AI segments
(all p < 0.001), but was also positively associated with the aortic bifurcation angle
(p < 0.001), both CIA planarities (left, p < 0.001; right, p = 0.002), aortic bifurcation
asymmetry (p = 0.001), and radius discrepancy (p < 0.001). Significant positive correlations
were found between infrarenal aortic TI/AAC and chronic kidney disease (CKD) (p =
0.027 and p = 0.016), AAC of both CIAs and hypertension (left, p = 0.027; right, p
= 0.012), right CIA take-off angle and CKD (p = 0.031), and left CIA planarity and
hyperlipidemia (p = 0.006). Conclusion: Sex, age, and CV risk factors have a significant
effect on the geometry of the AI segment.
