Imaging-Based Anatomical Characterization of Aortic Aneurysms and Dissections: An Observational Study in a Tertiary Hospital in Bogotá, Colombia

<i>Background and Objectives:</i> Aortic aneurysms and dissections are life-threatening vascular disorders with high morbidity and mortality. Enhancing diagnostic and therapeutic strategies requires a precise characterization of their anatomical and clinical features. This study aimed to detail the demographic, clinical, and imaging-based anatomical characteristics of aortic aneurysms and dissections in a cohort of Colombian patients. <i>Materials and Methods:</i> We conducted a retrospective, descriptive, observational study at a tertiary hospital in Bogotá, Colombia. Adult patients (≥18 years) with radiologically confirmed aortic aneurysm or dissection on computed tomography angiography (CTA) between 2010 and 2021 were included. Demographic, clinical, and morphological data were extracted. Associations were explored using chi-squared and Mann-Whitney U tests. Multivariate logistic regression was applied to identify independent predictors of in-hospital mortality. <i>Results:</i> This study included 539 patients (mean age: 69.3 ± 11.5 years; 53.6% male). Infrarenal abdominal aortic aneurysms were the most frequent (63.7%), with fusiform morphology observed in 92% of cases. Saccular aneurysms were significantly more common in females (<i>p</i> = 0.0267) and in non-infrarenal segments (<i>p</i> = 0.0162). Among patients with aneurysms, aortic diameter was an independent predictor of mortality (OR = 1.03; 95% CI: 1.01-1.05; <i>p</i> < 0.001). No individual variable significantly predicted mortality in dissection cases. <i>Conclusions:</i> In this cohort, infrarenal location and fusiform shape predominate. Morphological patterns were associated with sex and anatomical distribution. Although trends were observed, no statistically significant predictors of death were identified in dissection cases. These findings highlight the value of early detection and tailored management and reinforce the importance of generating region-specific data to inform clinical decision making in Latin American settings.