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Clinical and patho-anatomical factors affecting expansion of thoracic aortic aneurysms.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Bonser, Robert S. Pagano, Domenico Lewis, Michael E. Rooney, Stephen J. Guest, Peter J. Davies, Paul Shimada, Ichiro |
| Copyright Year | 2000 |
| Abstract | OBJECTIVE To examine the expansion of aneurysmal aortic segments (> or = 35 mm) and to assess the impact of clinical and patho-anatomical factors on aneurysm expansion. DESIGN 87 consecutive patients (mean age 63.6 years, range 22-84 years) were studied using serial (six month intervals) computed tomographic or magnetic resonance imaging to monitor progression of thoracic aortic aneurysms. Aortic diameter was measured at seven predetermined segments and at the site of maximum aortic dilatation (MAX). RESULTS 780 segment intervals were identified. The median overall aneurysm expansion rate was 1.43 mm/year. This increased exponentially with incremental aortic diameter (p < 0.01) and varied by anatomical segment (p < 0.05). The presence of intraluminal thrombus (p < 0.01) but not dissection or calcification was associated with accelerated growth. Univariate analysis identified thrombus (p < 0.001), previous stroke (p < 0.002), smoking (p < 0. 01), and peripheral vascular disease (p < 0.05) as factors associated with accelerated growth in MAX. Dissection, wall calcification, and history of hypertension did not affect expansion. beta Blocker treatment was not associated with protection. Multivariate analysis confirmed the positive effect of intraluminal thrombus and previous cerebral ischaemia, and the negative effect of previous aortic surgery on aneurysm growth. These findings translated into a mathematical equation describing exponential aneurysm expansion. CONCLUSIONS Aneurysmal thoracic aortic segments expand exponentially according to their initial size and their anatomical position within the aorta. The presence of intraluminal thrombus, atherosclerosis, and smoking history is associated with accelerated growth and may identify a high risk patient group for close surveillance. |
| Starting Page | 1 |
| Ending Page | 5 |
| Page Count | 5 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://heart.bmj.com/content/heartjnl/84/3/277.full.pdf |
| Alternate Webpage(s) | http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC1760947&blobtype=pdf |
| PubMed reference number | 10956290v1 |
| Volume Number | 84 |
| Issue Number | 3 |
| Journal | Heart |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anatomical position Aortic Aneurysm Aortic Aneurysm, Thoracic Aortic Valve Stenosis Atherosclerosis Brain Ischemia Calcinosis Cerebrovascular accident Chest Diameter (qualifier value) Dilate procedure Dissecting aneurysm of the thoracic aorta Hypertensive disease Increment Patients Peripheral Vascular Diseases Smoke Thrombosis beta Thalassemia |
| Content Type | Text |
| Resource Type | Article |
