Key result
Greater intraluminal thrombus wall coverage strongly predicts AAA progression.
Why the study?
To investigate the relationship between the characteristics of intraluminal thrombus and abdominal aortic aneurysm expansion.
Does the fraction of wall area covered by intraluminal thrombus predict the progression of abdominal aortic aneurysms in patients with AAA?
Observational (n=26)
No
Does the fraction of wall area covered by intraluminal thrombus predict the progression of abdominal aortic aneurysms in patients with AAA?
The fraction of the aortic wall area covered by intraluminal thrombus is a significant predictor of abdominal aortic aneurysm expansion, suggesting surgical intervention may be considered when this fraction exceeds 60%.
ILT characteristics may associate with AAA progression states; leaves open whether they predict expansion or warrant intervention in practice.
Objective To investigate the relationship between the characteristics of intraluminal thrombus (ILT) with abdominal aortic aneurysm (AAA) expansion. Methods This retrospective clinical study applied homogeneous multistate continuous-time Markov chain models to longitudinal computed tomography (CT) data from Korean patients with AAA. Four AAA states were considered (early, mild, severe, fatal) and the maximal thickness of the ILT (max ILT ), the fraction of the wall area covered by the ILT (area frac ) and the fraction of ILT volume (vol frac ) were used as covariates. Results The analysis reviewed longitudinal CT images from 26 patients. Based on likelihood-ratio statistics, the area frac was the most significant biomarker and max ILT was the second most significant. In addition, within AAAs that developed an ILT layer, the analysis found that the AAA expands relatively quickly during the early stage but the rate of expansion reduces once the AAA has reached a larger size. Conclusion The results recommend surgical intervention when a patient has an area frac more than 60%. Although this recommendation should be considered with caution given the limited sample size, physicians can use the proposed model as a tool to find such recommendations with their own data.
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Zhang et al. (2020) conducted an observational in Abdominal aortic aneurysms (n=26). Intraluminal thrombus (ILT) characteristics vs. Lower ILT characteristics was evaluated on Abdominal aortic aneurysm progression (transition between states) (p=0.0001). The fraction of the wall area covered by the intraluminal thrombus was the most significant biomarker for predicting abdominal aortic aneurysm progression (p=0.0001).
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