Computed Tomography Angiography Markers and Intraluminal Thrombus Morphology as Predictors of Abdominal Aortic Aneurysm Rupture

Emil Marian Arbănași, Adrian Vasile Mureșan, Cătălin Mircea Coșarcă (), Eliza Mihaela Arbănași, Raluca Niculescu, Septimiu Toader Voidăzan, Adrian Dumitru Ivănescu (), Ioana Hălmaciu, Rareș Cristian Filep, Lucian Mărginean, Shuko Suzuki, Traian V. Chirilă, Réka Kaller and Eliza Russu
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Emil Marian Arbănași: Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
Adrian Vasile Mureșan: Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania
Cătălin Mircea Coșarcă: Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania
Eliza Mihaela Arbănași: Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Raluca Niculescu: Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Septimiu Toader Voidăzan: Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Adrian Dumitru Ivănescu: Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Ioana Hălmaciu: Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Rareș Cristian Filep: Department of Radiology, Mures County Emergency Hospital, 540136 Targu Mures, Romania
Lucian Mărginean: Department of Radiology, Mures County Emergency Hospital, 540136 Targu Mures, Romania
Shuko Suzuki: Queensland Eye Institute, South Brisbane, QLD 4101, Australia
Traian V. Chirilă: Queensland Eye Institute, South Brisbane, QLD 4101, Australia
Réka Kaller: Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
Eliza Russu: Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania

IJERPH, 2022, vol. 19, issue 23, 1-13

Abstract: Background: Abdominal aortic aneurysm (AAA) is a complex vascular disease characterized by progressive and irreversible local dilatation of the aortic wall. Currently, the indication for repair is linked to the transverse diameter of the abdominal aorta, using computed tomography angiography imagery, which is one of the most used markers for aneurysmal growth. This study aims to verify the predictive role of imaging markers and underlying risk factors in AAA rupture. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included 220 patients over 18 years of age with a diagnosis of AAA, confirmed by computed tomography angiography (CTA), admitted to Vascular Surgery Clinic of Mures County Emergency Hospital in Targu Mures, Romania, between January 2018 and September 2022. Results: Patients with a ruptured AAA had higher incidences of AH ( p = 0.006), IHD ( p = 0.001), AF ( p < 0.0001), and MI ( p < 0.0001), and higher incidences of all risk factors (tobacco ( p = 0.001), obesity ( p = 0.02), and dyslipidemia ( p < 0.0001)). Multivariate analysis showed that a high baseline value of all imaging ratios markers was a strong independent predictor of AAA rupture (for all p < 0.0001). Moreover, a higher baseline value of DA max (OR:3.91; p = 0.001), SA max (OR:7.21; p < 0.001), and SLumen max (OR:34.61; p < 0.001), as well as lower baseline values of DA renal (OR:7.09; p < 0.001), DA CT (OR:12.71; p < 0.001), DA femoral (OR:2.56; p = 0.005), SA renal (OR:4.56; p < 0.001), SA CT (OR:3.81; p < 0.001), and SThrombus max (OR:5.27; p < 0.001) were independent predictors of AAA rupture. In addition, AH (OR:3.33; p = 0.02), MI (OR:3.06; p = 0.002), and PAD (OR:2.71; p = 0.004) were all independent predictors of AAA rupture. In contrast, higher baseline values of SA max /Lumen max (OR:0.13; p < 0.001) and ezetimibe (OR:0.45; p = 0.03) were protective factors against AAA rupture. Conclusions: According to our findings, a higher baseline value of all imaging markers ratios at CTA strongly predicts AAA rupture and AH, MI, and PAD highly predicted the risk of rupture in AAA patients. Furthermore, the diameter of the abdominal aorta at different levels has better accuracy and a higher predictive role of rupture than the maximal diameter of AAA.

Keywords: AAA; imaging markers; ILT; abdominal aortic aneurysm rupture; risk factors; computed tomography angiography (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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