Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms

Abstract

Purpose: To assess the most frequent deposition site of mural thrombi in infrarenal abdominal aorta aneurisms, as well as the route of the residual lumen. Methods: Assessment of CT scan images from 100 patients presenting asymptomatic abdominal aorta aneurism, and followed at HC-FMRP-USP. Results: In 53% of the cases the mural thrombus was deposited on the anterior wall; from these, in 22%, the residual lumen described a predominantly right sided route; in 22%, a left sided route; on the mid line in 5%; and crossing over the mid line in 1%. In 23%, the deposition of thrombi was concentric. In 11% it occured on the posterior wall; from these, in 5%, the route of the residual anterior lumen was predominantly right sided; in 5%, left sided; and crossed over the mid line in 1%. In 13% complex morfological deposition patterns were found. Conclusion: Mural thrombi formation was predominantly found on the anterior wall of the aneurismatic mass, with the route of the residual lumen projecting towards the posterior wall. Key-words:Abdominal Aorta Aneurisms. Thrombi and CT Scan. RESUMOObjetivos: Avaliar o local mais freqüente de deposição do trombo mural em aneurismas de aorta abdominal infrarenal, bem como o trajeto da luz residual. Métodos: Avaliação de tomografias de 100 pacientes do HC-FMRP-USP apresentando aneurisma de aorta abdominal assintomático. Resultados: O trombo mural se deposita na parede anterior em 53% dos casos, sendo que a luz residual posterior descreveu um trajeto predominantemente à direita em 22% dos casos, à esquerda em 22%, na linha mediana em 5% e cruzando da direita para a esquerda em 4%. 23% dos casos apresentaram deposição concêntrica do trombo e 11% apresentaram deposição na parede posterior, sendo o trajeto da luz residual anterior predominante a direita em 5% dos casos, a esquerda em 5% e cruzando a linha mediana em 1%. Padrões morfológicos complexos de deposição do trombo foram encontrados em 13% dos casos. Conclusão: A formação do trombo mural predominou na parede anterior da massa aneurismática, com o trajeto da luz residual se projetando para a parede posterior.Descritores: Aneurisma de Aorta Abdominal. Trombo e Tomografia Computadorizada por Raios X. Guimarães TAS et al 152

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

“…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].…”

Association of Aneurysm Tissue Neutrophil Mediator Levels with Intraluminal Thrombus Thickness in Patients with Abdominal Aortic Aneurysm

“…Moreover, there were differences in measured parameter concentrations between thin and thick ILT sections. wall adjacent to thin ILT vs. thin ILT (p = 0.03), 3 wall adjacent to thin ILT vs. thick ILT (p = 0.0004), 4 wall adjacent to thick ILT vs. thick ILT (p = 0.00002), 5 wall adjacent to thick ILT vs. thin ILT (p = 0.004), 6 wall adjacent to thin ILT vs. thin ILT (p = 0.01), 7 wall adjacent to thin ILT vs. thick ILT (p = 0.006), 8 wall adjacent to thin ILT vs. wall adjacent to thick ILT (p = 0.002), 9 wall adjacent to thin ILT vs. thin ILT (p = 0.006), 10 wall adjacent to thin ILT vs. thick ILT (p = 0.002), 11 wall adjacent to thick ILT vs. thick ILT (p = 0.0003), 12 wall adjacent to thick ILT vs. thin ILT (p = 0.0006), 13 wall adjacent to thin ILT vs. thin ILT (p = 0.0004), 14 wall adjacent to thin ILT vs. thick ILT (p = 0.0002), 15 wall adjacent to thick ILT vs. thick ILT (p = 0.003), 16 wall adjacent to thick ILT vs. thin ILT (p = 0.009), 17 wall adjacent to thin ILT vs. thin ILT (p = 0.02), 18 wall adjacent to thin ILT vs. thick ILT (p = 0.02), 19 wall adjacent to thin ILT vs. wall adjacent to thick ILT (p = 0.00005), 20 wall adjacent to thick ILT vs. thick ILT (p = 0.00005), 21 wall adjacent to thick ILT vs. thin ILT (p = 0.00004). 2 wall adjacent to thin ILT vs. thin ILT (p = 0.03), 3 wall adjacent to thin ILT vs. thick ILT (p = 0.0004), 4 wall adjacent to thick ILT vs. thick ILT (p = 0.00002), 5 wall adjacent to thick ILT vs. thin ILT (p = 0.004), 6 wall adjacent to thin ILT vs. thin ILT (p = 0.01), 7 wall adjacent to thin ILT vs. thick ILT (p = 0.006), 8 wall adjacent to thin ILT vs. wall adjacent to thick ILT (p = 0.002), 9 wall adjacent to thin ILT vs. thin ILT (p = 0.006), 10 wall adjacent to thin ILT vs. thick ILT (p = 0.002), 11 wall adjacent to thick ILT vs. thick ILT (p = 0.0003), 12 wall adjacent to thick ILT vs. thin ILT (p = 0.0006), …”

“…An AAA is usually asymmetric, and an ILT is often circumferential with the thickest part on the AAA’s ventral side [ 11 , 12 , 13 , 14 ]. The thickness of a thrombus and/or the aortic wall may differ between different patients or along each aneurysm [ 5 , 15 , 16 ].…”

“…Bars represent standard deviation. Significant results: 1 thin ILT vs. thick ILT (p = 0.03), 2wall adjacent to thin ILT vs. thin ILT (p = 0.03),3 wall adjacent to thin ILT vs. thick ILT (p = 0.0004),4 wall adjacent to thick ILT vs. thick ILT (p = 0.00002),5 wall adjacent to thick ILT vs. thin ILT (p = 0.004),6 wall adjacent to thin ILT vs. thin ILT (p = 0.01),7 wall adjacent to thin ILT vs. thick ILT (p = 0.006),8 wall adjacent to thin ILT vs. wall adjacent to thick ILT (p = 0.002),9 wall adjacent to thin ILT vs. thin ILT (p = 0.006),10 wall adjacent to thin ILT vs. thick ILT (p = 0.002),11 wall adjacent to thick ILT vs. thick ILT (p = 0.0003),12 wall adjacent to thick ILT vs. thin ILT (p = 0.0006),13 wall adjacent to thin ILT vs. thin ILT (p = 0.0004),14 wall adjacent to thin ILT vs. thick ILT (p = 0.0002),15 wall adjacent to thick ILT vs. thick ILT (p = 0.003),16 wall adjacent to thick ILT vs. thin ILT (p = 0.009),17 wall adjacent to thin ILT vs. thin ILT (p = 0.02),18 wall adjacent to thin ILT vs. thick ILT (p = 0.02),19 wall adjacent to thin ILT vs. wall adjacent to thick ILT (p = 0.00005),20 wall adjacent to thick ILT vs. thick ILT (p = 0.00005),21 wall adjacent to thick ILT vs. thin ILT (p = 0.00004).…”

A Relation Between Near-Wall Particle-Hemodynamics and Onset of Thrombus Formation in Abdominal Aortic Aneurysms

“…Their postulate is somewhat confirmed by multiple anatomic studies showing eccentric volume distributions of ILT with some prevalence seen in the distal anterior region of the AAA. 7,11,12,23 Based on a computational analysis, Rayz et al . 27 observed thrombus deposition in certain regions of three patient-specific geometries with an increase in “flow residence time” and low AAA wall shear stress.…”