Lembrechts Matthias, Desauw Lucas, Coudyzer Walter, Laenen Annouschka, Fourneau Inge, Maleux Geert
Department of Radiology, University Hospital Leuven, Leuven, Belgium.
Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
Eur Radiol Exp. 2024 Aug 1;8(1):88. doi: 10.1186/s41747-024-00489-3.
Our aim was to analyse abdominal aneurysm sac thrombus density and volume on computed tomography (CT) after endovascular aneurysm repair (EVAR).
Patients who underwent EVAR between January 2005 and December 2010 and had at least four follow-up CT exams available over the first five years of follow-up were included in this retrospective single-centre study. Thrombus density and aneurysm sac volume were calculated on unenhanced CT scans. Linear mixed models were used for data analysis.
Out of 82 patients, 44 (54%) had an endoleak on post-EVAR contrast-enhanced CT. Thrombus density significantly increased over time in both the endoleak and non-endoleak groups, with a slope of 0.159 UH/month (95% confidence interval [CI] 0.115-0.202), p < 0.0001) and 0.052 UH/month (95% CI 0.002-0.102, p = 0.041). In patients without endoleak, a significant decrease in aneurysm sac volume was identified over time (slope -0.891 cc/month, 95% CI -1.200 to -0.581); p < 0.001) compared to patients with endoleak (slope 0.284 cc/month, 95% CI -0.031 to 0.523, p = 0.082). The association between thrombus density and aneurysm sac volume was positive in the endoleak group (slope 1.543 UH/cc, 95% CI 0.948-2.138, p < 0.001) and negative in the non-endoleak group (slope -1.450 UH/cc, 95% CI -2.326 to -0.574, p = 0.001).
We observed a progressive increase in thrombus density of the aneurysm sac after EVAR in patients with and without endoleak, more pronounced in patients with endoleak. The association between aneurysm volume and thrombus density was positive in patients with and negative in those without endoleak.
A progressive increase in thrombus density and volume of abdominal aortic aneurysm sac on unenhanced CT might suggest underlying endoleak lately after EVAR.
Thrombus density of the aneurysm sac after EVAR increased over time. Progressive increase in thrombus density was significantly associated to the underlying endoleak. The association between aneurysm volume and thrombus density was positive in patients with and negative in those without endoleak.
我们的目的是分析血管内动脉瘤修复术（EVAR）后计算机断层扫描（CT）上腹主动脉瘤瘤体内血栓的密度和体积。
本回顾性单中心研究纳入了2005年1月至2010年12月期间接受EVAR且在随访的前五年至少有四次随访CT检查的患者。在未增强的CT扫描上计算血栓密度和动脉瘤瘤体体积。使用线性混合模型进行数据分析。
82例患者中，44例（54%）在EVAR术后的增强CT上存在内漏。内漏组和无内漏组的血栓密度均随时间显著增加，斜率分别为0.159 UH/月（95%置信区间[CI] 0.115 - 0.202，p < 0.0001）和0.052 UH/月（95% CI 0.002 - 0.102，p = 0.041）。在无内漏的患者中，与有内漏的患者相比（斜率0.284 cc/月，95% CI -0.031至0.523，p = 0.082），随着时间的推移，动脉瘤瘤体体积显著减小（斜率 -0.891 cc/月，95% CI -1.200至 -0.581；p < 0.001）。内漏组中血栓密度与动脉瘤瘤体体积之间呈正相关（斜率1.543 UH/cc，95% CI 0.948 - 2.138，p < 0.001），无内漏组中呈负相关（斜率 -1.450 UH/cc，95% CI -2.326至 -0.574，p = 0.001）。
我们观察到，无论有无内漏，EVAR术后患者动脉瘤瘤体内血栓密度均逐渐增加，内漏患者更为明显。有内漏患者的动脉瘤体积与血栓密度呈正相关，无内漏患者则呈负相关。
未增强CT上腹主动脉瘤瘤体内血栓密度和体积的逐渐增加可能提示EVAR术后存在潜在内漏。
EVAR术后动脉瘤瘤体内血栓密度随时间增加。血栓密度的逐渐增加与潜在内漏显著相关。有内漏患者的动脉瘤体积与血栓密度呈正相关，无内漏患者则呈负相关。
