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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Anatomical Differences Between Intact and Ruptured Large Abdominal Aortic Aneurysms.

Konstantinos Spanos1, Petroula Nana1, George Kouvelos1

  • 1Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
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PubMed
Summary

Large abdominal aortic aneurysms (AAA) with rupture show distinct anatomical features compared to intact AAAs. Key differences include aneurysm volume and left common iliac artery length, aiding in rupture risk assessment.

Keywords:
abdominal aortic aneurysmanatomyaneurysm volumeaortic neckiliac arteriesintraluminal thrombusmorphologyneck lengthrupture risk

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Area of Science:

  • Vascular Surgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Abdominal aortic aneurysms (AAA) pose a significant rupture risk.
  • Accurate estimation of rupture risk is crucial for timely intervention.
  • Anatomical characteristics may influence AAA rupture.

Purpose of the Study:

  • To compare anatomical differences between intact and ruptured large abdominal aortic aneurysms (rAAA).
  • To refine the estimation of AAA rupture risk based on anatomical features.

Main Methods:

  • Retrospective analysis of 62 male patients with large AAAs (>80 mm).
  • Comparison of anatomical characteristics using computed tomography angiography scans.
  • Multivariable regression and receiver operating characteristic (ROC) curve analyses.

Main Results:

  • Significant differences found in aortic neck, iliac artery dimensions, and aneurysm volumes.
  • Ruptured AAAs had larger total volumes and lower intraluminal thrombus (ILT) volume rates.
  • Shorter left common iliac artery (CIA) and smaller total aneurysm volume were associated with intact AAAs.

Conclusions:

  • Large rAAAs exhibit distinct anatomical traits compared to intact AAAs of similar size.
  • Shorter left CIA length (<50 mm) and smaller total aneurysm volume (<380 mL) predict lower rupture incidence.
  • These findings can improve AAA rupture risk stratification.