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A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
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Intraluminal thrombus: Innocent bystander or factor in abdominal aortic aneurysm pathogenesis?
1Department of Vascular Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
Jvs-Vascular Science
|October 7, 2021
Summary
Intraluminal thrombus (ILT) in abdominal aortic aneurysms (AAAs) is not benign. While potentially protective initially, growing ILT volume and age increase rupture risk by damaging the aortic wall.
Area of Science:
- Vascular Biology
- Biomedical Engineering
- Pathophysiology
Background:
- Abdominal aortic aneurysms (AAAs) are complex conditions involving hemodynamic, thrombotic, and inflammatory processes, often leading to fatal rupture.
- Despite advances in screening and surgery, AAA rupture mortality remains high, with limited nonoperative treatment options.
- Intraluminal thrombus (ILT), common in AAAs, is increasingly implicated in aneurysm pathogenesis.
Purpose of the Study:
- To review current clinical and experimental evidence on the role of intraluminal thrombus (ILT) in abdominal aortic aneurysm (AAA) growth and rupture.
- To examine the structure, composition, and hemodynamics of ILT formation and its relation to AAA wall degeneration.
- To discuss controversies and emerging evidence regarding ILT's impact on AAA rupture risk.
Main Methods:
- Literature review of PubMed database from 2012 to June 2020.
- Search terms included "abdominal aortic aneurysm" and "intraluminal thrombus."
- Analysis of clinical and experimental studies on ILT characteristics and AAA progression.
Main Results:
- ILT formation involves complex hemostatic and proteolytic factors.
- While ILT may initially reduce wall stress, evidence indicates increased ILT volume and age promote AAA wall degeneration.
- Controversies exist regarding ILT's position, thickness, and composition in relation to rupture risk.
Conclusions:
- Intraluminal thrombus (ILT) plays an active role in abdominal aortic aneurysm (AAA) pathophysiology, not merely as an "innocent bystander."
- Evidence suggests ILT promotes AAA wall degeneration, despite some computational models indicating a protective role against wall stress.
- Further research, particularly using chronic ILT models, is essential for understanding ILT's precise role and developing targeted therapies.
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