Intraluminal thrombus: Innocent bystander or factor in abdominal aortic aneurysm pathogenesis?

Boyd, April J.

doi:10.1016/j.jvssci.2021.02.001

Cited by 34 publications

(19 citation statements)

References 120 publications

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“…In recent years, many studies have shown that platelets play an important role in the develop-Biomolecules 2022, 12, 206 2 of 15 ment of AAA [9]. Low platelet count in patients with AAA suggested an increase in platelet consumption, and ILT formation in aortic aneurysm indicated platelet activation [10,11]. Platelet activation participates in AAA pathogenesis via membrane receptors and secreted mediators [12].…”

Section: Introductionmentioning

confidence: 99%

Targeting Platelet Activation in Abdominal Aortic Aneurysm: Current Knowledge and Perspectives

2022

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Abdominal aortic aneurysm (AAA) is a potentially fatal vascular disease that involves complex multifactorial hemodynamic, thrombotic, inflammatory, and aortic wall remodeling processes. However, its mechanisms are incompletely understood. It has become increasingly clear that platelets are involved in pathological processes of vascular diseases beyond their role in hemostasis and thrombosis. Platelet activation with membrane receptors and secreted mediators promotes thrombus formation and the accumulation of inflammatory cells, which may play an important role in the development of AAA by destroying the structural integrity and stability of the vessel wall. Turbulent blood flow in aortic aneurysms promotes platelet activation and aggregation. Platelet count and heterogeneity are important predictive, diagnostic, and prognostic indicators of AAA. We summarize the relationship between platelet activation and AAA development and propose future research directions and possible clinical applications.

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Section: Introductionmentioning

confidence: 99%

Targeting Platelet Activation in Abdominal Aortic Aneurysm: Current Knowledge and Perspectives

2022

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“…Moreover, an ILT volume greater than 51.6% correlates with severe adverse events, as shown in a multivariate analysis (HR: 2.90; p = 0.04) in a study published by Ding et al [ 44 ], which studied the case of 184 patients with AAA following endovascular aneurysm repair. In contrast, the descriptive review published by Boyd et al [ 45 ] emphasized the protective role of ILT by reducing wall stress.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Angiography Markers and Intraluminal Thrombus Morphology as Predictors of Abdominal Aortic Aneurysm Rupture

Arbănași

Mureșan

Coșarcă³

et al. 2022

IJERPH

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Background: Abdominal aortic aneurysm (AAA) is a complex vascular disease characterized by progressive and irreversible local dilatation of the aortic wall. Currently, the indication for repair is linked to the transverse diameter of the abdominal aorta, using computed tomography angiography imagery, which is one of the most used markers for aneurysmal growth. This study aims to verify the predictive role of imaging markers and underlying risk factors in AAA rupture. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included 220 patients over 18 years of age with a diagnosis of AAA, confirmed by computed tomography angiography (CTA), admitted to Vascular Surgery Clinic of Mures County Emergency Hospital in Targu Mures, Romania, between January 2018 and September 2022. Results: Patients with a ruptured AAA had higher incidences of AH (p = 0.006), IHD (p = 0.001), AF (p < 0.0001), and MI (p < 0.0001), and higher incidences of all risk factors (tobacco (p = 0.001), obesity (p = 0.02), and dyslipidemia (p < 0.0001)). Multivariate analysis showed that a high baseline value of all imaging ratios markers was a strong independent predictor of AAA rupture (for all p < 0.0001). Moreover, a higher baseline value of DAmax (OR:3.91; p = 0.001), SAmax (OR:7.21; p < 0.001), and SLumenmax (OR:34.61; p < 0.001), as well as lower baseline values of DArenal (OR:7.09; p < 0.001), DACT (OR:12.71; p < 0.001), DAfemoral (OR:2.56; p = 0.005), SArenal (OR:4.56; p < 0.001), SACT (OR:3.81; p < 0.001), and SThrombusmax (OR:5.27; p < 0.001) were independent predictors of AAA rupture. In addition, AH (OR:3.33; p = 0.02), MI (OR:3.06; p = 0.002), and PAD (OR:2.71; p = 0.004) were all independent predictors of AAA rupture. In contrast, higher baseline values of SAmax/Lumenmax (OR:0.13; p < 0.001) and ezetimibe (OR:0.45; p = 0.03) were protective factors against AAA rupture. Conclusions: According to our findings, a higher baseline value of all imaging markers ratios at CTA strongly predicts AAA rupture and AH, MI, and PAD highly predicted the risk of rupture in AAA patients. Furthermore, the diameter of the abdominal aorta at different levels has better accuracy and a higher predictive role of rupture than the maximal diameter of AAA.

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“…This study could only compute the WSS because it used computational fluid dynamics rather than the finite-element method, and it presumed that the ILT also reduced the WSS. WSS results were compared with those in a previous study by Boyd et al [41][42][43][44]. The geometry's maximal diameter was roughly 6.3 cm, indicating that it was highly prone to rupture, and they used a ruptured abdominal aortic aneurysm model without ILT in their investigation.…”

Section: Discussionmentioning

confidence: 99%

Does the Intraluminal Thrombus Provoke the Rupture of the Abdominal Aortic Aneurysm Wall?

Almijalli

2021

Applied Sciences

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The role of intraluminal thrombus (ILT) in the rupture of abdominal aortic aneurysms (AAA) is controversial, and it is unclear whether it increases or decreases the risk of rupture. This research aims to find a clear answer to this question. Previous computer modelling suggests that an ILT lowers oxygen dissemination to the AAA wall, contributing to wall thinning. The methodology used in this study determines the amount of oxygen reaching the aneurysm wall after passing through the ILT by using the porous nature of the ILT to recreate the condition as closely as feasible. Using computed tomographic images, patient-specific three-dimensional (3D) AAA geometries were recreated. Modelling blood and oxygen flow in AAA was obtained using a computational fluid dynamics (CFD) approach. Our findings indicated that the oxygen volume percentage had completely reached the aneurysm wall. Only at the inlet and outflow did the greatest wall shear stress (WSS) occur, with a significant drop in the central region of the aneurysm wall. CFD was used to calculate the velocity, pressure, and WSS of aortic blood flow. ILT had no effect on oxygen flow to the aneurysm wall, disproving the theory that it produces local hypoxia.

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Intraluminal thrombus: Innocent bystander or factor in abdominal aortic aneurysm pathogenesis?

Cited by 34 publications

References 120 publications

Targeting Platelet Activation in Abdominal Aortic Aneurysm: Current Knowledge and Perspectives

Targeting Platelet Activation in Abdominal Aortic Aneurysm: Current Knowledge and Perspectives

Computed Tomography Angiography Markers and Intraluminal Thrombus Morphology as Predictors of Abdominal Aortic Aneurysm Rupture

Does the Intraluminal Thrombus Provoke the Rupture of the Abdominal Aortic Aneurysm Wall?

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