Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Assessment of predictors of unstable abdominal aortic aneurysm wall by computed tomography

Authors: Getsadze G.G., Aslanidis I.P., Dorofeev A.V., Arakelyan V.S., Mamalyga M.L., Fedorchenko P.V.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2023-20-1-38-47

UDC: 616.136-007.64-073.756.8

Link: Clinical Physiology of Blood Circulaiton. 2023; 1 (20): 38-47

Quote as: Getsadze G.G., Aslanidis I.P., Dorofeev A.V., Arakelyan V.S., Mamalyga M.L., Fedorchenko P.V. Assessment of predictors of unstable abdominal aortic aneurysm wall by computed tomography. Clinical Physiology of Circulation. 2023; 20 (1): 38–47 (in Russ.). DOI: 10.24022/1814-6910-2023-20-1-38-47

Received / Accepted:  20.01.2023 / 17.03.2023

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Abstract

Objective. Determination of predictors of abdominal aortic aneurysm (AAA) wall instability and their thresholds, based on computed tomographic angiography (CTA).

Material and methods. 60 patients with infrarenal AАA were included in the study and divided into 2 groups: group 1 – with stable aortic wall, group 2 – with unstable aortic wall. The following parameters at different levels were assessed for each group: maximum vessel diameter and area of the vessel, lumen and wall at the level of the AАA proximal neck, at the level of the AАA maximum dilation and at the level of the terminal aorta; aneurysm extent; aneurysm area to normal vessel area ratio; thrombosis area to aneurysm area ratio; tangential stress of the aortic wall; degrees of aneurysm and entire abdominal aorta calcinosis. CT images were retrospectively analyzed on the image archiving and transmission system (Philips) workstation. Statistical analysis was performed using IBM SPSS (version 26).

Results. The study showed that wall instability occurred with a 35% increase in AАA area (p = 0.017) and a 1.3-fold increase in tangential tension (p = 0.007). The ratio of wall thrombosis area to aneurysm area is 72%. At the same time the lumen area does not change. ROC analysis revealed threshold values of unstable wall criteria: 1) maximum aneurysm size 58.7 mm; 2) aneurysm area 24.5 cm2, wall area 15.4 cm2; 3) ratio of AAA diameter to normal aortic diameter at diaphragm level 1.9; 4) ratio of wall thrombosis area to aneurysm area 0.66. Analysis of proximal neck, terminal section, extent and degree of calcification of aneurysm wall showed no significant changes in comparison with stable wall.

Conclusion. Analysis of the performed study showed the following threshold predictors of AAA wall instability: maximum AAA diameter – 5.9 cm; AAA area – 24.5 cm2; wall area with AAA parietal thrombus – 15.4 cm2; ratio of AAA diameter with normal aortic diameter at diaphragm level – 1.9; ratio of wall thrombosis area to aneurysm area – 0.66; AAA wall tension – 512 N/m2.

About Authors

  • Gela G. Getsadze, Radiologist; ORCID
  • Irakliy P. Aslanidis, Dr. Med. Sci., Professor, Deputy Director for Research, Head of Department of Nuclear Diagnostics; ORCID
  • Aleksey V. Dorofeev, Cand. Med. Sci., Head of Department of X-ray Diagnostics, CT and MRI; ORCID
  • Valeriy S. Arakelyan, Dr. Med. Sci., Professor, Head of Department of Arterial Pathology Surgery; ORCID
  • Maksim L. Mamalyga, Dr. Med. Sci., Senior Researcher; ORCID
  • Polina V. Fedorchenko, Radiologist; ORCID

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