Potential Influence of Intraluminal Thrombus on Abdominal Aortic Aneurysm As Assessed by a New Non-invasive Method

Intraluminal thrombus may play a role in abdominal aortic aneurysm pathogenesis and rupture. The purpose of this work was to demonstrate the feasibility of a new non-invasive method for the determination of the biomechanical features of the aortic wall and luminal boundary in abdominal aortic aneurysm containing intraluminal thrombus. Automated ultrasonographic measures of infrarenal aortic cross-sectional area (A) were obtained on-line along with non-invasive arterial pressure (p) from eight patients of mean (s.e.m.) age 74(3) years, with abdominal aortic aneurysm (mean dimensions 5.9(0.4) x 5.3(0.5) cm) containing intraluminal thrombus. Luminal boundary and abdominal aortic aneurysm wall were scanned separately. Compliance (C) was computed as C = (Amax - Amin)/[Amax(Pmax - Pmin)], where 'max and 'min' represent maximum and minimum values, respectively. Mean compliance was lower for the abdominal aortic aneurysm wall alone than for the luminal surface enclosed by intraluminal thrombus: 4.0(0.9) x 10(-4)/mmHg versus 9.8(1.7) x 10(-4)/mmHg (P < 0.01). Intraluminal thrombus area was nearly constant over the cardiac cycle, indicating that the thrombus is virtually incompressible. This noninvasive method to assess biomechanical features of abdominal aortic aneurysm has potential to further the understanding of the influences of intraluminal thrombus on aneurysm disease.