Growth rates and risk of rupture of abdominal aortic aneurysms

1998 ◽  
Vol 85 (12) ◽  
pp. 1674-1680 ◽  
Author(s):  
Vardulaki ◽  
Prevost ◽  
Walker ◽  
Day ◽  
Wilmink ◽  
...  
Keyword(s):  
Growth Rates ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Medical Treatment ◽  
Endovascular Treatment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Current Evidence ◽  
Significant Morbidity ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.

Systematic review and meta-analysis of growth rates of small abdominal aortic aneurysms

2011 ◽  
Vol 98 (5) ◽  
pp. 609-618 ◽  
Author(s):  
J. T. Powell ◽  
M. J. Sweeting ◽  
L. C. Brown ◽  
S. M. Gotensparre ◽  
F. G. Fowkes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Growth Rates ◽  
Meta Analysis ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic

Inflation Testing as a Means of Measuring Failure Strength of Aortic Tissue

2003 ◽  
Author(s):  
Jeffrey N. Kinkaid ◽  
Steven P. Marra ◽  
Francis E. Kennedy ◽  
Mark F. Fillinger
Keyword(s):  
United States ◽  
Abdominal Aortic Aneurysms ◽  
The United States ◽  
Aortic Aneurysms ◽  
Aortic Tissue ◽  
Failure Strength ◽  
Health Statistics ◽  
Mortality Risks ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal Aortic Aneurysms (AAAs) are localized enlargements of the aorta. If untreated, AAAs will grow irreversibly until rupture occurs. Ruptured AAAs are usually fatal and are a leading cause of death in the United States, killing 15,000 per year (National Center for Health Statistics, 2001). Surgery to repair AAAs also carries mortality risks, so surgeons desire a reliable tool to evaluate the risk of rupture versus the risk of surgery.

Abstract 13513: Serial CT Surveillance of Abdominal Aortic Aneurysm Diameter Demonstrates Predominantly Linear Growth (N-TA 3 CT)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sydney Olson ◽  
Marniker Wijesinha ◽  
Annalise Panthofer ◽  
William Blackwelder ◽  
Gilbert R Upchurch ◽  
...  
Keyword(s):  
Growth Rate ◽  
Growth Rates ◽  
Linear Growth ◽  
Growth Patterns ◽  
Aortic Aneurysms ◽  
Transverse Diameter ◽  
Invasive Treatment ◽  
Abdominal Aortic ◽  
Risk Of Rupture ◽  
Serial Ct

Objective: Small abdominal aortic aneurysms (AAAs) have a low risk of rupture. Intervention is indicated when diameters exceed established thresholds. This study assessed the growth rates and patterns of AAAs over 2 years as documented on serial CT scans from the Non-Invasive Treatment of AAA Clinical Trial. Methods: 254 patients, 35 females with baseline AAA maximum transverse diameter (MTD) between 3.5-4.5 cm and 219 males with baseline MTD 3.5-5.0 cm, were included in this study. Linear regressions and segmental growth rates were used to model growth rates and patterns. Results: The yearly growth rates of AAA MTDs had a median of 0.17 cm/yr and mean of 0.19 cm/yr ± 0.14 (Figure 1). 10% of AAA displayed minimal to no growth (< 0.05 cm/yr), 62% low growth (0.05-0.25 cm/yr), 28% high growth (> 0.25 cm/yr). Baseline AAA diameter accounted for only 5.4% of growth rate variance (P<0.001, R 2 0.05). Most AAAs displayed linear growth (70%); large variations in interval growth rates occurred infrequently (3% staccato growth, 4% exponential growth); a minority of subjects’ growth patterns were not clearly classifiable (11% indeterminate-not growing, 12% indeterminate-growing) (Figure 2). No patients with baseline MTD < 4.25 cm exceeded sex-specific repair thresholds (males 0 / 92, [95% CI, 0.00-0.06]; females 0 / 25 [95% CI, 0.00-0.25]) in the course of follow-up for as long as two years. Conclusions: The majority of small AAAs exhibit linear growth; large intra-patient growth rate variations were infrequently observed over 2 years. AAA < 4.25 cm can be followed with a CT scan in 2 years with little chance of exceeding interventional MTD thresholds of 5.5 cm for men.

Abstract 261: Neutrophil Elastase Derived Fibrin Degradation Products are Increased in the Plasma of Patients with Abdominal Aortic Aneurysms and Correlate to the Intraluminal Thrombus Volume

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Joy Roy ◽  
Angela Silveira ◽  
Moritz Liljeqvist Lindquist ◽  
Maggie Folkesson ◽  
Siw Frebelius ◽  
...  
Keyword(s):  
Degradation Products ◽  
Sandwich Elisa ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Maximum Diameter ◽  
Intraluminal Thrombus ◽  
Fibrin Degradation Products ◽  
Aortic Repair ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Introduction: Abdominal Aortic Aneurysms (AAA) often contain an intraluminal thrombus (ILT). AAA diameter and ILT volume are associated with growth of the aneurysm. Neutrophils, present in the ILT, contain elastase (NE). NE activity leads to production of fibrin degradation products (FDPs) with a specific epitope [[Unable to Display Character: &#8211;]] XDP. The present study evaluates NE-derived FDPs in aneurysm patients scheduled for elective aortic repair. The purpose of the study is to introduce an additional bio-marker for presence of AAA and possibly risk of rupture by measuring levels of NE derived FDPs in plasma of patients with AAA. Materials and Methods: 42 male patients, undergoing aortic repair for AAA were included. As controls, we collected blood samples from 42 men who attended an AAA screening program but had no AAAs on ultrasound. Computed Tomography (CT) images were available for 34 AAA patients and analyzed using A4 Clinics software (VASCOPS, Austria). Patient demographics, maximum diameter, aortic volume and ILT volume were recorded. Peak wall stress (PWS), peak wall rupture index (PWRI) and mean ILT stress were estimated by Finite Element Analysis using the A4 Clinics software. Plasma levels of elastase digests of cross-linked fibrin (E-XDP) were determined with a sandwich ELISA. Results: E-XDP levels were higher in AAA patients than in age-matched controls (8.5 vs 1.2 U/ml, p<0.0001). E-XDP levels correlated with ILT volume (r = 0.64, p<0.0001), aortic volume (r = 0.64, p<0.0001) and maximum diameter (r = 0.59, p=0.0003). AAA patients with other concomitant peripheral aneurysms had higher E-XDP levels than those with only an AAA (13.6 vs 6.8 U/ml, p=0.028). PWS, PWRI and bleeding signs in the thrombus did not significantly affect E-XDP levels. Interestingly, the mean ILT stress correlated significantly to E-XDP levels (r= 0.45, p=0.008). Conclusions: The study shows that it is feasible to measure E-XDP levels in plasma of patients with AAA and that E-XDP correlates with ILT volume and mean ILT stress. These results support the notion that the resident neutrophils in the ILT can actively lyse fibrin in the ILT, which may decrease ILT strength. E-XDP holds potential as a biomarker of the ILT in AAA patients and needs to be further investigated in AAA rupture risk assessment.

Pulsatile Flow in Fusiform Models of Abdominal Aortic Aneurysms: Flow Fields, Velocity Patterns and Flow-Induced Wall Stresses

2004 ◽  
Vol 126 (4) ◽  
pp. 438-446 ◽  
Author(s):  
Robert A. Peattie ◽  
Tiffany J. Riehle ◽  
Edward I. Bluth
Keyword(s):  
Shear Stress ◽  
Pulsatile Flow ◽  
Maximum Shear Stress ◽  
Wall Stress ◽  
Abdominal Aortic Aneurysms ◽  
Flow Fields ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Risk Of Rupture

As one important step in the investigation of the mechanical factors that lead to rupture of abdominal aortic aneurysms, flow fields and flow-induced wall stress distributions have been investigated in model aneurysms under pulsatile flow conditions simulating the in vivo aorta at rest. Vortex pattern emergence and evolution were evaluated, and conditions for flow stability were delineated. Systolic flow was found to be forward-directed throughout the bulge in all the models, regardless of size. Vortices appeared in the bulge initially during deceleration from systole, then expanded during the retrograde flow phase. The complexity of the vortex field depended strongly on bulge diameter. In every model, the maximum shear stress occurred at peak systole at the distal bulge end, with the greatest shear stress developing in a model corresponding to a 4.3 cm AAA in vivo. Although the smallest models exhibited stable flow throughout the cycle, flow in the larger models became increasingly unstable as bulge size increased, with strong amplification of instability in the distal half of the bulge. These data suggest that larger aneurysms in vivo may be subject to more frequent and intense turbulence than smaller aneurysms. Concomitantly, increased turbulence may contribute significantly to wall stress magnitude and thereby to risk of rupture.

Prediction of Abdominal Aortic Aneurysms Using Sparse Gaussian Process Regression

2013 ◽  
Author(s):  
A. Ijaz ◽  
J. Choi ◽  
W. Lee ◽  
S. Baek
Keyword(s):  
Gaussian Process ◽  
Morphological Changes ◽  
Gaussian Process Regression ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Risk Of Rupture ◽  
Spatial Estimates ◽  
Spatio Temporal ◽  
Small Aneurysms

Abdominal Aortic Aneurysms (AAA) is a form of vascular disease causing focal enlargement of abdominal aorta. It affects a large part of population and has up to 90% mortality rate. Since risks from open surgery or endovascular repair outweighs the risk of AAA rupture, surgical treatments are not recommended with AAA less than 5.5cm in diameter. Recent clinical recommendations suggest that people with small aneurysms should be examined 3∼36 months depending on size to get information about morphological changes. While advances in biomechanics provide state-of-the-art spatial estimates of stress distributions of AAA, there are still limitations in modeling its time evolution. Thus, there is no biomechanical framework to utilize such information from a series of medical images that would aid physicians in detecting small aneurysms with high risk of rupture. For the present study, we use series of CT images of small AAAs taken at different times to model and predict the spatio-temporal evolution of AAA. This is achieved using sparse local Gaussian process regression.

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