Effect of Thrombus on Abdominal Aortic Aneurysm Wall Dilation and Stress

Overview

Journal J Cardiovasc Surg (Torino)

Specialties Cardiology & Vascular Diseases
General Surgery

Date 2003 Mar 11

PMID 12627076

Citations 25

Authors

M J Thubrikar

F Robicsek

M Labrosse

V Chervenkoff

B L Fowler

Affiliations

Soon will be listed here.

Abstract

Aim: Our goal is to understand how a mural thrombus may influence the pressure transmitted to and the dilation experienced by the abdominal aortic aneurysm (AAA) wall.

Methods: Two intact AAAs with mural thrombus were removed from patients and pressurized to 100 mmHg. The pressure was measured using a micro-tip needle transducer inserted in the aneurysm wall and advanced through the thrombus. In 1 patient with AAA, similar measurements were made in vivo. Also, in vitro, in the two aneurysms the dilation as a function of pressure was measured using the markers on the surface before and after the thrombus was removed.

Results: Both, in vitro and in vivo, in the presence of the thrombus the pressure transmitted to the aneurysm wall was 91+/-10% of luminal pressure and at 6 mm from the wall it was 96+/-5%. The aneurysm dilated more in the pressure range of 0-40 mmHg (2-8%) than in the range of 40-100 mmHg (0.4-1.8%). Upon removal of the thrombus these dilations increased significantly to 4-15% and 0.9-3.3%, respectively. Overall, the strains (dilation) in the circumferential and longitudinal directions were similar before the thrombus was removed.

Conclusions: Even though the thrombus allows the transmission of luminal pressure to the aneurysm wall, it may prevent the aneurysm from rupture by diminishing the strain on the wall. Consistent with this, a mechanical model of the thrombus proposed is "a thrombus as a fibrous network adherent to the aneurysm wall".

Citing Articles

High-density thrombus and maximum transverse diameter on multi-spiral computed tomography angiography combine to predict abdominal aortic aneurysm rupture.

Liu H, Chen Z, Tang C, Fan H, Mai X, Cai J Front Cardiovasc Med. 2022; 9:951264.

PMID: 36247433 PMC: 9561396. DOI: 10.3389/fcvm.2022.951264.

The Detrimental Role of Intraluminal Thrombus Outweighs Protective Advantage in Abdominal Aortic Aneurysm Pathogenesis: The Implications for the Anti-Platelet Therapy.

Ma X, Xia S, Liu G, Song C Biomolecules. 2022; 12(7).

PMID: 35883500 PMC: 9313225. DOI: 10.3390/biom12070942.

Abdominal Aortic Aneurysm Morphology as an Essential Criterion for Stratifying the Risk of Aneurysm Rupture.

Niklas N, Gutowski P, Kazimierczak A, Rynio P J Clin Med. 2022; 11(4).

PMID: 35207223 PMC: 8875520. DOI: 10.3390/jcm11040933.

Translating mouse models of abdominal aortic aneurysm to the translational needs of vascular surgery.

Busch A, Bleichert S, Ibrahim N, Wortmann M, Eckstein H, Brostjan C JVS Vasc Sci. 2021; 2:219-234.

PMID: 34778850 PMC: 8577080. DOI: 10.1016/j.jvssci.2021.01.002.

A Predictive Analysis of Wall Stress in Abdominal Aortic Aneurysms Using a Neural Network Model.

Rengarajan B, Patnaik S, Finol E J Biomech Eng. 2021; 143(12).

PMID: 34318314 PMC: 8420793. DOI: 10.1115/1.4051905.