Growth rate, diameter at rupture, and associated patient characteristics of abdominal aortic aneurysms without an intraluminal thrombus.

Authors

Moritz Lindquist Liljeqvist, Asta Joshi, Antti Siika, Marko Bogdanovic, Patricia Andersson, Stefan Stoisavljevic, Rebecka Hultgren, Joy Roy

Published in

JVS-vascular science. Volume 7. Pages 100430. Epub Jul 14, 2026.

Abstract

The aim of this study was to provide clinical and prognostic data on the small share of abdominal aortic aneurysms (AAAs) devoid of an intraluminal thrombus (ILT).
Three retrospective samples were studied: electively treated patients (n = 234, growth rates available for n = 158 and an early baseline computed tomography [CT] available for n = 128), patients with rupture (n = 133), and those followed in surveillance (n = 161). Growth rates of electively treated AAAs were calculated based on all measurements preceding surgery. ILT thickness was measured perpendicularly to the aneurysms' centerline and was defined as absent if no intraluminal contrast deficit was detected, minimal if the ILT thickness was <5 mm, and present when ≥5 mm.
ILT was absent and minimal in 4.8% and 3.2%, respectively, in the preoperative CT of the electively treated AAAs. Patients with absent/minimal ILT appeared to suffer less cardiovascular burden, but there were no differences in anticoagulation. Absent/minimal ILT was associated with a smaller AAA diameter at baseline (P = 1.6e-5) and at the last preoperative CT (P = .0048). There were however no associations between absent/minimal ILT and growth after a baseline CT (n = 128; P = .67) or preceding a preoperative CT (n = 158; P = .091; P adjusted for diameter = 0.27). There were similar shares of absent/minimal ILTs in the elective and ruptured AAA groups (8% and 9%, respectively, P = .66). AAAs with absent/minimal ILTs ruptured at smaller aneurysm diameters (median, 68 vs 79 mm; P = .036) and absent/minimal ILT was associated with rupture adjusted for diameter (P = .037) but not when also adjusting for other patient characteristics (P = .89). Similar results were observed in the cohort of patients with AAAs under surveillance.
The absence of ILT is more common in smaller AAAs but is not associated with growth rate. AAAs without ILT seem to rupture at smaller diameters, but ILT absence is not an independent rupture risk factor.
The present study analyzed patients with abdominal aortic aneurysms (AAA) that do not develop an intraluminal thrombus (ILT). It was shown that the absence of ILT was associated with smaller maximal diameters in asymptomatic and ruptured AAAs, but there was no difference in growth rate between the groups, and the absence of ILT was not an independent risk factor for rupture. Collectively, these data did not support specific management considerations in patients with AAAs without an ILT.

PMID:
42633261
Bibliographic data and abstract were imported from PubMed on 23 Aug 2026.

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