Computed tomography scanning findings associated with rapid expansion of abdominal aortic aneurysms

Wolf, Yehuda G.; Thomas, W. S.; Brennan, Frank J.; Goff, Walter G.; Sise, Michael J.; Bernstein, Eugene F.

doi:10.1016/0741-5214(94)90277-1

Cited by 165 publications

(138 citation statements)

References 18 publications

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“…In human AAAs, it has also been reported that a rapid lesion expansion was associated with an increased ILT load [20]. However, in very few rats, large AAAs occurred with no or a very small-sized ILT.…”

Section: Discussionmentioning

confidence: 99%

Thrombus versus Wall Biological Activities in Experimental Aortic Aneurysms

Coutard¹,

Touat²,

Houard³

et al. 2009

J Vasc Res

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Background/Aim: The intraluminal thrombus (ILT) is considered to participate in abdominal aortic aneurysm (AAA) evolution. To assess whether this role proceeds via ILT influence on biological activity of the AAA wall, we studied the relationships between the levels of some relevant proteases and microparticles (MP) released by ILT versus wall in rat experimental AAAs. Methods and Results: Two weeks after elastase perfusion, ILT and AAA wall were incubated in cell culture medium and studies were performed on conditioned media. As shown by gelatin zymography, ILT released higher amounts of MMP9 than the wall, whereas the level of MMP2 activation (active/pro) was similar. Levels of elastase and urokinase plasminogen activator, plasmin and MPs, determined, respectively, by casein zymography, substrate hydrolysis and flow cytometry, were higher in ILT than in wall. Aneurysm diameter positively correlated with wall MMP9 levels, MMP2 activation, plasmin activity and MP release. Moreover, wall and ILT levels of pro- and active forms of MMP2, elastase and plasmin were positively correlated. Wall levels of MMP2 activation and plasmin activity also correlated with ILT weight. Conclusion: The present data suggest that, in this experimental model, ILT may contribute to AAA evolution via its influence on the level of aneurysmal wall protease activity.

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Section: Discussionmentioning

confidence: 99%

Thrombus versus Wall Biological Activities in Experimental Aortic Aneurysms

Coutard¹,

Touat²,

Houard³

et al. 2009

J Vasc Res

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“…Particle trajectories were governed by _ xðtÞ ¼ uðx; tÞ (1) where u was the fluid field velocity obtained from CFD. A domain of interest X was defined to encompass the entire aneurysmal region (Fig.…”

Section: Lagrangian Approachmentioning

confidence: 99%

“…It is often accompanied by the growth of ILT, and ILT formation has been linked to both the progression [1] and risk of rupture [2] of AAA. The mechanisms of ILT formation, as well as the influence of ILT on AAA biomechanics, however, are complex and poorly understood [3,4].…”

Section: Introductionmentioning

confidence: 99%

Mechanical Platelet Activation Potential in Abdominal Aortic Aneurysms

Hansen

Arzani

Shadden

2015

Journal of Biomechanical Engineering

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Intraluminal thrombus (ILT) in abdominal aortic aneurysms (AAA) has potential implications to aneurysm growth and rupture risk; yet, the mechanisms underlying its development remain poorly understood. Some researchers have proposed that ILT development may be driven by biomechanical platelet activation within the AAA, followed by adhesion in regions of low wall shear stress. Studies have investigated wall shear stress levels within AAA, but platelet activation potential (AP) has not been quantified. In this study, patient-specific computational fluid dynamic (CFD) models were used to analyze stressinduced AP within AAA under rest and exercise flow conditions. The analysis was conducted using Lagrangian particle-based and Eulerian continuum-based approaches, and the results were compared. Results indicated that biomechanical platelet activation is unlikely to play a significant role for the conditions considered. No consistent trend was observed in comparing rest and exercise conditions, but the functional dependence of AP on stress magnitude and exposure time can have a large impact on absolute levels of anticipated platelet AP. The Lagrangian method obtained higher peak AP values, although this difference was limited to a small percentage of particles that falls below reported levels of physiologic background platelet activation.

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“…Some authors have suggested that the thrombus would function as a protecting factor for the aneurismatic wall against the hemodynamic stress; 10 others report the thrombus as a factor predisposing to rupture 13 and associate it with the weakening of the aneurismatic wall. [14][15] …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2008

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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

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Computed tomography scanning findings associated with rapid expansion of abdominal aortic aneurysms

Abstract: An increased AAA thrombus load is associated with a higher likelihood of rapid expansion and should weigh in favor of early surgical repair.

Cited by 165 publications

References 18 publications

Thrombus versus Wall Biological Activities in Experimental Aortic Aneurysms

Thrombus versus Wall Biological Activities in Experimental Aortic Aneurysms

Mechanical Platelet Activation Potential in Abdominal Aortic Aneurysms

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

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