Right-sided Aortic Torsion in Patients with Abdominal Aortic Aneurysms.

IF 1.4 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Annals of vascular surgery Pub Date : 2025-03-17 DOI:10.1016/j.avsg.2025.02.028

Anirudh Chandrashekar, Luis Leon, Lachlan Smith, Nicos Labropoulos

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引用次数: 0

Abstract

Objectives: Altered flow dynamics within abdominal aortic aneurysms (AAA) may lead to changes in aneurysmal geometry, intraluminal thrombus (ILT) deposition, or aneurysmal progression. Aortic torsion is one geometric deviation that has been clinically observed but has not been formally evaluated in pre-operative AAAs. This pilot retrospective cohort study investigates the degree and directionality of aortic torsion in patients with and without AAAs.

Methods: The inferior mesenteric artery (IMA-Angle) outlet angle was used to assess aortic torsion. Angles were measured with respect to the anterior-posterior axis in both aneurysmal (370) and non-aneurysmal (120) patients. Patient age, gender, maximum infrarenal aortic/AAA diameter (D_Max), and presence/percentage of ILT were calculated.

Results: 370 AAA patients (Age: 74 [65:83], %Male: 88%, D_Max: 50.1 mm [41.9 - 57.0 mm]) were retrospectively identified. ILT was present in 65% of cases and comprised 26.2% of the aneurysmal sac [18.6 - 36.7%]. Similarly, 120 patients without aneurysmal disease were identified (Age: 70 [63:81], %Male: 79%, D_Max: 23.3 mm [21.5 - 25.6]). Median IMA-Angle [25th-75th%] in the aneurysmal cohort was 17.0° [8.6° - 25.3°] and closer to the AP axis compared to controls (38.5° [34.3° - 44.9°], p < 0.001). Presence, percentage, and classification of ILT (r = 0.01, p = 0.93) had negligible impact on IMA outlet angle.

Conclusion: This study highlights the right-sided IMA preference in AAA patients compared to non-aneurysmal controls. The pathophysiology underlying this rotation may be associated with a right-sided helical flow pattern in expanding aneurysmal sacs. This sets the foundation for future investigations.

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来源期刊

Annals of vascular surgery 医学-外科

CiteScore

3.00

自引率

13.30%

发文量

603

审稿时长

50 days

期刊介绍： Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence