Giant abdominal aortic aneurysms

Ng, Joshua; Nguyen, Tri Minh; Tarpara, Anand; Salvatore, Dawn; DiMuzio, Paul; Abai, Babak

doi:10.1016/j.jvscit.2021.04.016

Cited by 8 publications

(5 citation statements)

References 37 publications

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“…In our study, only COPD was significantly more prevalent in patients with a large AAA. The obtained results are in accordance with the literature data showing that atherosclerotic changes and cardiovascular diseases are the most common comorbidities among patients with aortic aneurysm disease [17]. Jones W. et al [11], found a lower prevalence of comorbidities in patients with a small AAA, which can be explained by the selection of patients.…”

Section: Discussionsupporting

confidence: 91%

The impact of abdominal aortic aneurysm diameter on the outcome of endovascular aortic repair

et al. 2021

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Introduction. Abdominal aortic aneurysm diameter is one of the most important parameters in the diagnostic and therapeutic algorithm for aneurysm follow-up. Currently, two therapeutic modalities are used: open surgery and endovascular aortic repair. The aim of this study is to analyze the impact of the maximum transverse diameter of the abdominal aortic aneurysm on the incidence of general and specific complications. Material and Methods. The retrospective study included 75 patients with infrarenal abdominal aortic aneurysm who underwent endovascular aortic repair in the period from July 2008 to January 2020. The patients were divided into two groups: group A with an abdominal aortic aneurysm size ? 5.9 cm, and group B with an abdominal aortic aneurysm size ? 6.0 cm. Results. A total of 41.3% of patients presented with a maximum transverse aneurysm diameter of ? 5.9 cm, and 58.7% of patients had ? 6.0 cm. Of comorbid diseases, chronic obstructive pulmonary disease was more prevalent in patients with a large abdominal aortic aneurysm (group A 25.8%; group B 59.1%). None of the other comorbidities showed a statistically significant difference between the two groups of patients. Early complications were present in a total of 14.7% of patients, of which 12.9% of patients with a small and 15.9% with a large abdominal aortic aneurysm. Late complications occurred in a total of 18.7% of patients, in 9.7% of patients with a small and 25% of patients with a large abdominal aortic aneurysm. Conclusion. Patients with abdominal aortic aneurysms with a maximum transverse diameter of 6 cm and larger, present with a higher rate of late postoperative complications, increase in aneurysmal sac on control multislice computed tomography angiography, and have a worse prognosis compared to patients with smaller abdominal aortic aneurysms.

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Section: Discussionsupporting

confidence: 91%

The impact of abdominal aortic aneurysm diameter on the outcome of endovascular aortic repair

et al. 2021

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“…3 E, F). Per patient, the percentual underestimation of the CT volume by US is mostly constant with increasing size of the partial volume region, with an average of 11[ 5 – 8 ] % for volumes of 30 mm long.…”

Section: Resultsmentioning

confidence: 99%

“…There is however quite some heterogeneity in the progression of the disease, with some AAAs showing no growth for several years, or even shrinkage, while other AAAs grow as much as 1.3 cm/year [ 3 – 5 ]. Furthermore, there is variation in the diameter at which rupture occurs between patients: some smaller abdominal aneurysms of less than 5 cm rupture [ 6 ], while other larger aneurysms stay stable, even up to diameters of 20 cm [ 7 , 8 ]. These differences in growth and risk of rupture might be related to differences in the way that the aortic wall adapts to the changes in wall deformation as well as the load (pressure, blood flow pattern) it experiences while the AAA grows [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

3D-Ultrasound Based Mechanical and Geometrical Analysis of Abdominal Aortic Aneurysms and Relationship to Growth

et al. 2023

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The heterogeneity of progression of abdominal aortic aneurysms (AAAs) is not well understood. This study investigates which geometrical and mechanical factors, determined using time-resolved 3D ultrasound (3D + t US), correlate with increased growth of the aneurysm. The AAA diameter, volume, wall curvature, distensibility, and compliance in the maximal diameter region were determined automatically from 3D + t echograms of 167 patients. Due to limitations in the field-of-view and visibility of aortic pulsation, measurements of the volume, compliance of a 60 mm long region and the distensibility were possible for 78, 67, and 122 patients, respectively. Validation of the geometrical parameters with CT showed high similarity, with a median similarity index of 0.92 and root-mean-square error (RMSE) of diameters of 3.5 mm. Investigation of Spearman correlation between parameters showed that the elasticity of the aneurysms decreases slightly with diameter (p = 0.034) and decreases significantly with mean arterial pressure (p < 0.0001). The growth of a AAA is significantly related to its diameter, volume, compliance, and surface curvature (p < 0.002). Investigation of a linear growth model showed that compliance is the best predictor for upcoming AAA growth (RMSE 1.70 mm/year). To conclude, mechanical and geometrical parameters of the maximally dilated region of AAAs can automatically and accurately be determined from 3D + t echograms. With this, a prediction can be made about the upcoming AAA growth. This is a step towards more patient-specific characterization of AAAs, leading to better predictability of the progression of the disease and, eventually, improved clinical decision making about the treatment of AAAs.

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“…The repair of type II endoleak involves coil embolization of the blood vessels that are feeding the aneurysmal sac. Different imaging methods like CT, ultrasound (US), and magnetic resonance imaging (MRI) have been described for surveillance [ 5 ]; however, there is no clear consensus regarding how often the surveillance [ 6 ], and the benefit of early intervention vs continuous surveillance [ 2 ]. There are different studies that incline toward either approach.…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal aortic aneurysms (AAA) are considered large when they exceed >6cm, and giant when they exceed >10cm in the maximum transverse diameter [ 1 ]. Giant AAAs are rare, with only a very few cases described as larger than 14cm [ 2 ]. Thoracic and abdominal AAAs can be successfully repaired through endovascular aneurysm repair (EVAR) or open surgery [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

An Unusual Case of Giant Abdominal Aortic Aneurysm Due to Type II Endoleak Persistent Failure

Perez¹,

Menchaca²,

Ostos³

et al. 2022

Cureus

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Abdominal aortic aneurysms (AAA) are considered giant when they exceed >10cm, and they are rare, with only a few cases described as >14cm. AAAs can be repaired through endovascular aneurysm repair (EVAR) or open surgery. EVAR involves the placement of a graft that contacts the aortic wall and the iliac vessels to prevent the aneurysm sac to have blood flow and pressure. One of the complications of EVAR is endoleak, the most common being type II. We describe an uncommon case of a progressively giant AAA with type II endoleak with poor evolution despite multiple repair attempts.

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Giant abdominal aortic aneurysms

Cited by 8 publications

References 37 publications

The impact of abdominal aortic aneurysm diameter on the outcome of endovascular aortic repair

The impact of abdominal aortic aneurysm diameter on the outcome of endovascular aortic repair

3D-Ultrasound Based Mechanical and Geometrical Analysis of Abdominal Aortic Aneurysms and Relationship to Growth

An Unusual Case of Giant Abdominal Aortic Aneurysm Due to Type II Endoleak Persistent Failure

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