Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic Aneurysm
<b>Background:</b> An intraluminal, non-occlusive thrombus (ILT) is a common feature in an abdominal aortic aneurysm (AAA). This study investigated the relative progression of ILT vs. AAA volume using a novel parameter, the so-called thrombus burden ratio (TBR), in non-treated AAAs. Para...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/4/962 |
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| author | Joscha Mulorz Agnesa Mazrekaj Justus Sehl Amir Arnautovic Waseem Garabet Kim-Jürgen Krott Hubert Schelzig Margitta Elvers Markus Udo Wagenhäuser |
| author_facet | Joscha Mulorz Agnesa Mazrekaj Justus Sehl Amir Arnautovic Waseem Garabet Kim-Jürgen Krott Hubert Schelzig Margitta Elvers Markus Udo Wagenhäuser |
| author_sort | Joscha Mulorz |
| collection | DOAJ |
| description | <b>Background:</b> An intraluminal, non-occlusive thrombus (ILT) is a common feature in an abdominal aortic aneurysm (AAA). This study investigated the relative progression of ILT vs. AAA volume using a novel parameter, the so-called thrombus burden ratio (TBR), in non-treated AAAs. Parameters potentially associated with TBR progression were analyzed and TBR progression in large vs. small and fast- vs. slow-growing AAAs was assessed. <b>Methods:</b> This retrospective, single-center study analyzed sequential contrast-enhanced computed tomography angiography (CTA) scans between 2009 and 2018 from patients with an AAA before surgical treatment. Patients’ medical data and CTA scans were analyzed at two given time points. The TBR was calculated as a ratio of ILT and AAA volume, and relative TBR progression was calculated by normalization for time between sequential CTA scans. Spearman’s correlation was applied to identify morphologic parameters correlating with TBR progression, and multivariate linear regression analysis was used to evaluate the association of clinical and morphological parameters with TBR progression. <b>Results:</b> A total of 35 patients were included. The mean time between CT scans was 16 ± 15.9 months. AAA volume progression was 12 ± 3% and ILT volume progression was 36 ± 13%, resulting in a TBR progression of 11 ± 4%, suggesting overproportioned ILT growth. TBR progression was 0.8 ± 0.8% per month. Spearman’s correlation verified ILT growth as the most relevant parameter contributing to TBR progression (R = 0.51). Relative TBR progression did not differ significantly in large vs. small and fast- vs. slow-growing AAAs. In the multivariate regression analysis, none of the studied factors were associated with TBR progression. <b>Conclusion:</b> TBR increases during AAA development, indicating an overproportioned ILT vs. AAA volume growth. The TBR may serve as a useful parameter, as it incorporates the ILT volume growth relative to the AAA volume, therefore combining two important parameters that are usually reported separately. Yet, the clinical relevance in helping to identify potential corresponding risk factors and the evaluation of patients at risk needs to be further validated in a larger study cohort. |
| first_indexed | 2024-03-07T22:28:03Z |
| format | Article |
| id | doaj.art-d8ae5c94e23445fd8402be177d833e8d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-07T22:28:03Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d8ae5c94e23445fd8402be177d833e8d2024-02-23T15:21:54ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-0113496210.3390/jcm13040962Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic AneurysmJoscha Mulorz0Agnesa Mazrekaj1Justus Sehl2Amir Arnautovic3Waseem Garabet4Kim-Jürgen Krott5Hubert Schelzig6Margitta Elvers7Markus Udo Wagenhäuser8Clinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, GermanyClinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, GermanyClinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, GermanyClinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, GermanyClinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, GermanyClinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, GermanyClinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, GermanyClinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, GermanyClinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, 40225 Düsseldorf, Germany<b>Background:</b> An intraluminal, non-occlusive thrombus (ILT) is a common feature in an abdominal aortic aneurysm (AAA). This study investigated the relative progression of ILT vs. AAA volume using a novel parameter, the so-called thrombus burden ratio (TBR), in non-treated AAAs. Parameters potentially associated with TBR progression were analyzed and TBR progression in large vs. small and fast- vs. slow-growing AAAs was assessed. <b>Methods:</b> This retrospective, single-center study analyzed sequential contrast-enhanced computed tomography angiography (CTA) scans between 2009 and 2018 from patients with an AAA before surgical treatment. Patients’ medical data and CTA scans were analyzed at two given time points. The TBR was calculated as a ratio of ILT and AAA volume, and relative TBR progression was calculated by normalization for time between sequential CTA scans. Spearman’s correlation was applied to identify morphologic parameters correlating with TBR progression, and multivariate linear regression analysis was used to evaluate the association of clinical and morphological parameters with TBR progression. <b>Results:</b> A total of 35 patients were included. The mean time between CT scans was 16 ± 15.9 months. AAA volume progression was 12 ± 3% and ILT volume progression was 36 ± 13%, resulting in a TBR progression of 11 ± 4%, suggesting overproportioned ILT growth. TBR progression was 0.8 ± 0.8% per month. Spearman’s correlation verified ILT growth as the most relevant parameter contributing to TBR progression (R = 0.51). Relative TBR progression did not differ significantly in large vs. small and fast- vs. slow-growing AAAs. In the multivariate regression analysis, none of the studied factors were associated with TBR progression. <b>Conclusion:</b> TBR increases during AAA development, indicating an overproportioned ILT vs. AAA volume growth. The TBR may serve as a useful parameter, as it incorporates the ILT volume growth relative to the AAA volume, therefore combining two important parameters that are usually reported separately. Yet, the clinical relevance in helping to identify potential corresponding risk factors and the evaluation of patients at risk needs to be further validated in a larger study cohort.https://www.mdpi.com/2077-0383/13/4/962aortic aneurysmintraluminal thrombusaneurysm researchaneurysm growth |
| spellingShingle | Joscha Mulorz Agnesa Mazrekaj Justus Sehl Amir Arnautovic Waseem Garabet Kim-Jürgen Krott Hubert Schelzig Margitta Elvers Markus Udo Wagenhäuser Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic Aneurysm Journal of Clinical Medicine aortic aneurysm intraluminal thrombus aneurysm research aneurysm growth |
| title | Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic Aneurysm |
| title_full | Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic Aneurysm |
| title_fullStr | Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic Aneurysm |
| title_full_unstemmed | Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic Aneurysm |
| title_short | Relative Thrombus Burden Ratio Reveals Overproportioned Intraluminal Thrombus Growth—Potential Implications for Abdominal Aortic Aneurysm |
| title_sort | relative thrombus burden ratio reveals overproportioned intraluminal thrombus growth potential implications for abdominal aortic aneurysm |
| topic | aortic aneurysm intraluminal thrombus aneurysm research aneurysm growth |
| url | https://www.mdpi.com/2077-0383/13/4/962 |
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