Measurement and determinants of infrarenal aortic thrombus volume

Golledge, Jonathan; Wolanski, Philippe; Parr, Adam; Büttner, Petra

doi:10.1007/s00330-008-0956-3

Cited by 55 publications

(43 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As previously reported, we confirmed an association between AAA diameter and the volume of the intra-aneurysmal thrombus [33]–[35]. The role of the intra-aneurysmal thrombus for AAA progression, however, is still controversial: several studies demonstrated that the size of an intra-aneurysmal thrombus is related to AAA progression and/or rupture [12], [36]–[38].…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Antiphospholipid Antibodies Predict Progression of Abdominal Aortic Aneurysms

et al. 2014

View full text Add to dashboard Cite

Antiphospholipid antibodies (aPLs) frequently occur in autoimmune and cardiovascular diseases and correlate with a worse clinical outcome. In the present study, we evaluated the association between antiphospholipid antibodies (aPLs), markers of inflammation, disease progression and the presence of an intra-aneurysmal thrombus in abdominal aortic aneurysm (AAA) patients.APLs ELISAs were performed in frozen serum samples of 96 consecutive AAA patients and 48 healthy controls yielding positive test results in 13 patients (13.5%) and 3 controls (6.3%; n.s.). Nine of the 13 aPL-positive AAA patients underwent a second antibody testing >12 weeks apart revealing a positive result in 6 cases. APL-positive patients had increased levels of inflammatory markers compared to aPL-negative patients. Disease progression was defined as an increase of the AAA diameter >0.5 cm/year measured by sonography. Follow-up was performed in 69 patients identifying 41 (59.4%) patients with progressive disease. Performing multipredictor logistic regression analysis adjusting for classical AAA risk factors as confounders, the presence of aPLs at baseline revealed an odds ratio of 9.4 (95% CI 1.0–86.8, p = 0.049) to predict AAA progression. Fifty-five patients underwent a computed tomography in addition to ultrasound assessment indicating intra-aneurysmal thrombus formation in 82.3%. Median thrombus volume was 46.7 cm3 (1.9–377.5). AAA diameter correlated with the size of the intra-aneurysmal thrombus (corrcoeff = 0.721, p<0.001), however neither the presence nor the size of the intra-aneurysmal thrombus were related to the presence of aPLs.In conclusion, the presence of aPLs is associated with elevated levels of inflammatory markers and is an independent predictor of progressive disease in AAA patients.

show abstract

Section: Discussionsupporting

confidence: 90%

“…This finding is in line with others showing that a thrombus may even reduce shear-stress imposed on the AAA wall [39]–[41]. In summary, the factors determining whether an intra-aneurysmal thrombus increases the risk for AAA progression or protects against deterioration of the disease are still unknown [35].…”

Section: Discussionsupporting

confidence: 88%

Antiphospholipid Antibodies Predict Progression of Abdominal Aortic Aneurysms

et al. 2014

View full text Add to dashboard Cite

show abstract

“…A recent study demonstrated a close correlation between thrombus volume and both total aortic volume (r=0.87, p <0.0001) and maximum AAA diameter (r=0.74, p <0.0001) 72. This was in keeping with previous smaller studies which quantified AAA thrombus 73,74.…”

Section: Risk Factors Of Aaasupporting

confidence: 85%

“…Calcification,109,110 and thrombus volumes,72 have been assessed in research settings with excellent reproducibility. In a study involving 75 patients, accurate assessment of thrombus volume using CTA was evidenced by low intra- (Pearson correlation coefficient 0.9974 (P<0.001), mean coefficient of variation 2.9%), and inter-observer (Pearson correlation coefficient 0.9983 (P<0.001), mean coefficient of variation 4.3%) variation 72. However, assessment is hindered by difficulty in delineation of surrounding anatomy and thrombus and high time requirements.…”

Section: Current Diagnosis Of Aaamentioning

confidence: 99%

Diagnosis and Monitoring of Abdominal Aortic Aneurysm: Current Status and Future Prospects

Moxon

Parr²,

Emeto³

et al. 2010

Current Problems in Cardiology

Self Cite

130

148

View full text Add to dashboard Cite

Abdominal aortic aneurysm (AAA) remains an important cause of morbidity and mortality in elderly men, and prevalence is predicted to increase in parallel with a global ageing population. AAA is commonly asymptomatic, and in the absence of routine screening, diagnosis is usually incidental when imaging to assess unrelated medical complaints. In the absence of approved diagnostic and prognostic markers, AAAs are monitored conservatively via medical imaging until aortic diameter approaches 50-55mm and surgical repair is performed. There is currently significant interest in identifying molecular markers of diagnostic and prognostic value for AAA. Here we outline the current guidelines for AAA management, and discuss modern scientific techniques currently employed to identify improved diagnostic and prognostic markers. KeywordsAbdominal aortic aneurysm; diagnosis; prognosis; biomarker INTRODUCTIONAn abdominal aortic aneurysm (AAA) is a dilation of the infra-renal aorta, which appears to result from chronic weakening of the arterial wall, increasing the risk of fatal rupture.1 -3 AAA is also associated with an increased risk of other major cardiovascular events in aneurysmal patients. For example the UK small aneurysm trial (UKSAT), demonstrated that only 16% of deaths in patients with 40-55mm AAAs was related to AAA repair or rupture while ~50% were due to other cardiovascular causes (mainly myocardial infarction and stroke).4 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access AAA pathologyMacroscopically, an AAA can be considered a dilatation of the infrarenal aorta, giving rise to a permanent vessel diameter >30mm (typical abdominal aortic diameter ranges from 15 to 25mm). 23-27 AAA vessel dilation is commonly progressive, and is often accompanied by the formation of a laminated, non-occlusive, intraluminal thrombus.28 -29 Thrombus size and location varies between patients, and the arterial wall may be partially or completely covered by the thrombus ( Figure 1A and B). 30 The thrombus remains in permanent contact with circulating blood and is continually remodeled, 31,32 and thrombus size increases in parallel with aortic dilation. Due to constant remodeling the thrombus is a laminated structure comprising a red blood cell-rich luminal layer in contact with the flowing blood, progressing to a brown fibrinolysed layer at the aortic wall. 29 Localised hypoxia has been demonstrated in regions of the aorta covered by the thrombus and this has been suggested to contribute to physiological stresses within the arterial wall. 33 Similar to other vascular dise...

show abstract

“…Intraluminal thrombus is a feature of most AAAs and is correlated with the size of the aneurysm [67]. Thrombus has been suggested to be important in AAA pathogenesis by releasing proteolytic enzymes and proinflammatory cytokines from inflammatory cells trapped within fibrin [68].…”

Section: Aortic Thrombus and Antithrombotic Therapiesmentioning

confidence: 99%