ORIGINAL ARTICLE  AORTIC DISEASE Editor’s choice • Free

International Angiology 2019 February;38(1):39-45

DOI: 10.23736/S0392-9590.18.04006-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Effect of intraluminal thrombus on growth rate of abdominal aortic aneurysms

Andrej DOMONKOS ¹ ✉, Robert STAFFA ^{1, 2}, Luboš KUBÍČEK ^{1, 2}

¹ Faculty of Medicine, Masaryk University, Brno, Czech Republic; ² Second Department of Surgery, Center for Vascular Disease, St. Anne’s University Hospital and Faculty of Medicine, Brno, Czech Republic

BACKGROUND: Abdominal aortic aneurysm (AAA) includes a variety of morphologies with changing properties. Growth rate is one of the most important factors directly linked to the risk of rupture. Intraluminal thrombus (ILT) covering aortic wall is found in the majority of AAAs. Yet, its role in biomechanical processes in AAA remains unclear. From one point of view ILT can serve as protective factor in reducing wall stress of AAA and thus slow down the growth. Modern concept of multilayered ILT proved active inflammatory processes inside, that can significantly affect the quality of the wall and thus lead to a higher growth rate and higher risk of rupture. The goal of this study was to analyze the effect of ILT on growth rate of AAA and support one of these theories.
METHODS: Retrospective study of computed tomography angiography scans of AAA of 26 patients was performed. Forty pairs of consecutive scans have been analyzed. Periods between two scans varied. Maximal infrarenal diameter of AAA and size of ILT were measured. AAAs were split into 4 groups according to their initial diameter. Growth rate was calculated for each AAA and linked to the relative size of ILT. These values were statistically evaluated.
RESULTS: Negative correlation between relative size of ILT and growth rate was found (P=0.042062). This significant result proved that thicker thrombus slowed down the growth of AAA and vice versa, smaller relative size of ILT was linked to higher growth rate.
CONCLUSIONS: This finding shows importance of ILT as one of the key factors influencing biomechanical processes inside an AAA. Results of this study may contribute to future researches of this topic.

KEY WORDS: Aortic aneurysm, abdominal - Thrombosis - Computed tomography angiography