Key result
The presence of intraluminal thrombus in abdominal aortic aneurysms was associated with a faster median growth rate compared to aneurysms without thrombus (2.0 mm/y vs 1.0 mm/y; P<0.001).
Why the study?
Intraluminal thrombus within abdominal aortic aneurysms may be a potential marker for subsequent aneurysm growth, but its role in progression assessed by CT and MRI needed investigation.
Does the presence of intraluminal thrombus predict a faster annual growth rate in male patients with abdominal aortic aneurysms?
Cohort (n=225)
No
Does the presence of intraluminal thrombus predict a faster annual growth rate in male patients with abdominal aortic aneurysms?
Absolute Event Rate: 2% vs 1%
p-value: p=<.001
The presence of intraluminal thrombus is an independent predictor of more rapid abdominal aortic aneurysm growth, particularly in small (3-4 cm) aneurysms.
May support closer surveillance of AAAs with intraluminal thrombus; leaves open whether thrombus modifies rupture risk or intervention thresholds.
Background Intraluminal thrombus (ILT) within abdominal aortic aneurysms (AAAs) may be a potential marker for subsequent aneurysm growth. Purpose To investigate the role of ILT in AAA progression as assessed with CT and MRI. Materials and Methods This was a retrospective study, with patient data included from January 2004 to December 2018 at a Veteran Affairs medical center. Male patients with AAA who underwent contrast material–enhanced CT at baseline and CT or black-blood MRI at follow-up (minimal follow-up duration of 6 months) were included. The maximal AAA diameter was measured with multiplanar reconstruction, and the annual growth rate of aneurysms was calculated. Uni- and multivariable linear regression analyses were used to determine the relationship between demographic and imaging factors and aneurysm growth. Results A total of 225 patients (mean age, 72 years ± 9 [standard deviation]) were followed for a mean of 3.3 years ± 2.5. A total of 207 patients were followed up with CT, and 18 were followed up with MRI. At baseline, the median size of the AAA was 3.8 cm (interquartile range [IQR], 3.3–4.3 cm); 127 of 225 patients (54.7%) had ILT. When compared with AAAs without ILT, AAAs with ILT had larger baseline diameters (median, 4.1 cm [IQR, 3.6–4.8 cm] vs 3.4 cm [IQR, 3.2–3.9 cm]; P < .001) and faster growth rates (median, 2.0 mm/y [IQR, 1.3–3.2 mm/y] vs 1.0 mm/y [IQR, 0.4–1.8 mm/y]; P < .001). Small AAAs (size range, 3–4 cm) with ILT grew 1.9-fold faster than did those without ILT (median, 1.5 mm/y [IQR, 0.9–2.7 mm/y] vs 0.8 mm/y [IQR, 0.3–1.5 mm/y]; P < .001). Medium AAAs (size range, 4–5 cm) with ILT had 1.2-fold faster growth than did those without ILT (median growth, 2.1 mm/y [IQR, 1.4, 3.7 mm/y] vs 1.8 mm/y [IQR, 0.9, 2.0 mm/y]; P = .06). In multivariable analysis, baseline diameter and ILT were independently positively related to aneurysm growth rate (standardized regression coefficient, 0.43 [P < .001] and 0.15 [P = .02], respectively). Conclusion Both maximal cross-sectional aneurysm diameter and the presence of intraluminal thrombus are independent predictors of abdominal aortic aneurysm growth.
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Zhu et al. (2020) conducted a cohort in Abdominal aortic aneurysms (n=225). Intraluminal thrombus vs. No intraluminal thrombus was evaluated on annual growth rate of aneurysms (p=<.001). The presence of intraluminal thrombus in abdominal aortic aneurysms was associated with a faster median growth rate compared to aneurysms without thrombus (2.0 mm/y vs 1.0 mm/y; P<0.001).
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