Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jan;53(1):28-35.
doi: 10.1016/j.jvs.2010.08.013.

Thrombus volume is associated with cardiovascular events and aneurysm growth in patients who have abdominal aortic aneurysms

Adam Parr  1 , Moira McCann, Barbara Bradshaw, Anwar Shahzad, Petra Buttner, Jonathan Golledge
Affiliations

Thrombus volume is associated with cardiovascular events and aneurysm growth in patients who have abdominal aortic aneurysms

Adam Parr et al. J Vasc Surg. 2011 Jan.

Abstract

Background: Patients with abdominal aortic aneurysms (AAA) are predisposed to cardiovascular events and often experience continual expansion of their aneurysm. Cardiovascular events and expansion rates are positively correlated with aneurysm size. AAA is usually associated with intraluminal thrombus, which has previously been implicated in AAA pathogenesis. This study prospectively assessed the association of infrarenal abdominal aortic thrombus volume with cardiovascular events and AAA growth.

Methods: Ninety-eight patients with AAAs underwent computed tomography angiography (CTA). The volume of infrarenal aorta thrombus was measured by a previously validated technique. Patients were monitored prospectively for a median of 3 years (interquartile range [IQR], 2.0-3.6 years), and cardiovascular events (nonfatal stroke, nonfatal myocardial infarction, coronary revascularization, amputation, and cardiovascular death) were recorded. Of the original patients, 39 underwent repeat CTA a median of 1.5 years (IQR, 1.1-3.3 years) after entry to the study. Kaplan-Meier and Cox proportional analysis were used to examine the association of aortic thrombus with cardiovascular events and average weighted AAA growth.

Results: There were 28 cardiovascular events during follow-up. The incidence of cardiovascular events was 23.4% and 49.2% for patients with small (smaller than the median) and large (median or larger) volumes of aortic thrombus, respectively, at 4 years (P = .040). AAA thrombus volume of median or larger was associated with increased cardiovascular events (relative risk [RR] 2.8, 95% confidence interval [CI], 1.01-5.24) independent of other risk factors, including initial AAA diameter, but was only of borderline significance when patients were censored at the time of AAA repair (RR, 2.35; 95% CI, 0.98-5.63). In the subset of patients with CTA follow-up, the median annual increase in AAA volume was 5.1 cm³ (IQR, 0.8-10.3 cm³). Annual AAA volume increase was positively correlated with initial AAA diameter (r = 0.44, P = .006) and thrombus volume (r = 0.50, P = .001). Median or larger aortic thrombus volume was associated with rapid AAA volume increase (≥ 5 cm/y), independent of initial aortic diameter (RR, 15.0; 95% CI, 1.9-115.7; P = .009).

Conclusion: In this small cohort, infrarenal aortic thrombus volume was associated with the incidence of cardiovascular events and AAA progression. These results need to be confirmed and mechanisms underlying the associations clarified in large further studies.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan Meier analysis showing freedom from cardiovascular events in patients with small (<26.0cm3) and large (>26.0cm3) AAA thrombus volumes. * = cardiovascular event rate at 4 years.
Figure 2
Figure 2
Kaplan Meier analysis showing freedom from cardiovascular events in patients with small (<45.0mm) and large (≥45.0mm) diameter AAAs. * = cardiovascular event rate at 4 years.
Figure 3
Figure 3
Scatterplots displaying the association of annual abdominal aortic volume change with thrombus volume (a.) and maximal axial abdominal aortic diameter (b.).
See this image and copyright information in PMC

References

    1. Norman PE, Jamrozik K, Lawrence-Brown MM, et al. Population based randomised controlled trial on impact of screening on mortality from abdominal aortic aneurysm. BMJ. 2004 November 27;329(7477):1259. - PMC - PubMed
    1. Brady AR, Fowkes FGR, Thompson SG, et al. Aortic Aneurysm Diameter and Risk of Cardiovascular Mortality. Arterioscler Thromb Vasc Biol. 2001 July 1;21(7):1203–7. - PubMed
    1. Norman P, Le M, Pearce C, et al. Infrarenal Aortic Diameter Predicts All-Cause Mortality. Arterioscler Thromb Vasc Biol. 2004 July 1;24(7):1278–82. - PubMed
    1. Brady AR, Thompson SG, Fowkes FGR, et al. Abdominal Aortic Aneurysm Expansion: Risk Factors and Time Intervals for Surveillance. Circulation. 2004 July 6;110(1):16–21. - PubMed
    1. Vega de Ceniga M, Gomez R, Estallo L, et al. Growth Rate and Associated Factors in Small Abdominal Aortic Aneurysms. European Journal of Vascular and Endovascular Surgery. 2006;31(3):231–6. - PubMed

Publication types

MeSH terms