Analysis of Expansion Patterns in 4-4.9 cm Abdominal Aortic Aneurysms

Céniga, Melina Vega de; Gómez, R.; Estallo, L.; Fuente, Natalia de la; Viviens, B.; Barba, A.

doi:10.1016/j.avsg.2007.07.036

Cited by 45 publications

(34 citation statements)

References 34 publications

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“…Platelets then preferentially attach to pre-existing ILT or to the distal regions of the vessel (AAA). This is supported by multiple anatomic studies of ILT, as it commonly occurs in the distal anterior region of AAA [23,[41][42][43]. In 2012, an integrated fluid-chemical approach for modelling ILT formation in AAA was introduced by Biasetti et al which showed agreement with the site specificity of ILT formation and the movement of vortex structures [44].…”

Section: Introductionmentioning

confidence: 91%

A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm

Kelsey

Powell

Norman

et al. 2016

Numer Methods Biomed Eng

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Aneurysms of the common iliac artery (CIAA) are most commonly seen in association with an abdominal aortic aneurysm (AAA). Isolated CIAAs, in the absence of an AAA, are uncommon. Similar to AAAs, CIAA may develop intraluminal thrombus (ILT). As isolated CIAAs have a contralateral common iliac artery for comparison, they provide an opportunity to study the haemodynamic mechanisms behind ILT formation.In this study, we compared a large isolated CIAA and the contralateral iliac artery using computational fluid dynamics (CFD) to determine if haemodynamic metrics correlate with the location of ILT. We performed a comprehensive CFD study and investigated the residence time of platelets and monocytes, velocity fields, time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI) and endothelial cell activation potential (ECAP). We then correlated these data to ILT burden determined with computed tomography (CT).We found that high cell residence times, low TAWSS, high OSI and high ECAP all correlate with regions of ILT development. Our results show agreement with previous hypotheses of thrombus formation in AAA and provide insights into the computational haemodynamics of iliac artery aneurysms.

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Section: Introductionmentioning

confidence: 91%

A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm

Kelsey

Powell

Norman

et al. 2016

Numer Methods Biomed Eng

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“…The publication dates of the 15 potentially eligible studies 13,22,[29][30][31][32][33][34][35][36][37][38][39][40][41] ranged from 1994 to 2009, with patient recruitment from 1976 to 2005. Of these, 10 were prospective studies 13,22,[34][35][36][37][38][39][40][41] (including three randomised trials), four included both retrospective and prospective data 29,30,32,33 and one study reported only retrospective data.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Of these, 10 were prospective studies 13,22,[34][35][36][37][38][39][40][41] (including three randomised trials), four included both retrospective and prospective data 29,30,32,33 and one study reported only retrospective data. 31 Aneurysm growth was the primary outcome measure in 10 of the 15 studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Some studies used CT as well as US. 22,29,33 Most of these studies included aortic diameters from 30 mm (at baseline), except three studies, which reported from either 25 mm 31,35 or 28 mm. 13 Not all studies restricted their reporting to the aneurysm diameter range of interest (3.0-5.5 cm) and in some instances substudies were identified, which reported on a more restricted range.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…13 Not all studies restricted their reporting to the aneurysm diameter range of interest (3.0-5.5 cm) and in some instances substudies were identified, which reported on a more restricted range. 13,29,33 Different methods were used to estimate aneurysm growth, usually reported as mm/year, with linear regression or (last-first diameter)/time being the most common; two studies did not report how they estimated aneurysm growth. 29,36 One study only reported percentage changes in aneurysm diameter and used data from two screening programmes (Chichester and Huntingdon).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Thompson

Brown²,

Sweeting³

et al. 2013

Health Technology Assessment

186

177

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This report should be referenced as follows:Thompson SG, Brown LC, Sweeting MJ, Bown MJ, Kim LG, Glover MJ, et al. Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness. Health Technol Assess 2013;17(41). Health Technology Assessment is indexed in MEDLINE, CINAHL, EMBASE, The Cochrane Library and the ISI Science Citation Index and is assessed for inclusion in the Database of Abstracts of Reviews of Effects. Health Technology Assessment is indexed and abstracted inThis journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/30/02. The contractual start date was in November 2009. The draft report began editorial review in July 2012 and was accepted for publication in November 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research...

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Evaluating Growth Patterns of Abdominal Aortic Aneurysm Diameter With Serial Computed Tomography Surveillance

et al. 2021

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IMPORTANCE Small abdominal aortic aneurysms (AAAs) are common in the elderly population. Their growth rates and patterns, which drive clinical surveillance, are widely disputed.OBJECTIVE To assess the growth patterns and rates of AAAs as documented on serial computed tomography (CT) scans. DESIGN, SETTING, AND PARTICIPANTSCohort study and secondary analysis of the Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (N-TA 3 CT), a randomized, double-blind placebo-controlled clinical trial conducted from 2013 to 2018, with CT imaging every 6 months for 2 years. The trial was a multicenter, observational secondary analysis, not related to treatment hypotheses of data collected in the N-TA 3 CT. Participants included 254 patients with baseline AAA diameter between 3.5 and 5.0 cm. EXPOSURES Patients received serial CT scan measurements, analyzed for maximum transverse diameter, at 6-month intervals. MAIN OUTCOMES AND MEASURESThe primary study outcome was AAA annual growth rate. Secondary analyses included characterizing AAA growth patterns, assessing likelihood of AAA diameter to exceed sex-specific intervention thresholds over 2 years.RESULTS A total of 254 patients, 35 women with baseline AAA diameter 3.5 to 4.5 cm and 219 men with baseline diameter 3.5 to 5.0 cm, were included. Yearly growth rates of AAA diameters were a median of 0.17 cm/y (interquartile range [IQR], 0.16) and a mean (SD), 0.19 (0.14) cm/y. Ten percent of AAAs displayed minimal to no growth (<0.05 cm/y), 62% displayed low growth (0.05-0.25 cm/y), and 28% displayed high growth (>0.25 cm/y). Baseline AAA diameter accounted for 5.4% of variance of growth rate (P < .001; R 2 , 0.054). Most AAAs displayed linear growth (70%); large variations in interval growth rates occurred infrequently (3% staccato growth and 4% exponential growth); and some patients' growth patterns were not clearly classifiable (23% indeterminate). No patients with a maximum transverse diameter less than 4.25 cm exceeded sex-specific repair thresholds at 2 years (men, 0 of 92; 95% CI, 0.00-0.055; women, 0 of 25 ; 95% CI, 0.00-0.247). Twenty-six percent of patients with a maximum transverse diameter of at least 4.25 cm exceeded sex-specific repair thresholds at 2 years (n = 12 of 83 men with diameter ranging from 4.25 to <4.75 cm; 95% CI, 0.091-0.264; n = 21 of 44 men with diameter ranging from 4.75-5.0 cm; 95% CI, 0.362-0.669; n = 3 of 10 women with diameter Ն4.25 cm; 95% CI, 0.093-0.726).CONCLUSIONS AND RELEVANCE Most small AAAs showed linear growth; large intrapatient variations in interval growth rates were infrequently observed over 2 years. Linear growth modeling of AAAs in individual patients suggests smaller AAAs (<4.25 cm) can be followed up with a CT scan in at least 2 years with little chance of exceeding interventional thresholds.

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Analysis of Expansion Patterns in 4-4.9 cm Abdominal Aortic Aneurysms

Cited by 45 publications

References 34 publications

A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm

A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Evaluating Growth Patterns of Abdominal Aortic Aneurysm Diameter With Serial Computed Tomography Surveillance

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