BACKGROUND:Abdominal aortic aneurysm (AAA) is a major cause of mortality among older men. Current clinical practice primarily determines the indication for elective AAA repair based on the maximum aneurysm diameter. However, this approach may not adequately capture the complexity of individual rupture risk, and intraluminal thrombus (ILT) has been associated with increased growth and rupture risk. In other vascular beds, non-O blood types are correlated with an increased risk of thrombosis. This study investigates the association between ABO blood type and ILT volume in AAA patients. METHODS:A cross-sectional analysis of patients with infrarenal AAAs from the Copenhagen Aortic Cohort (COACH) assessed AAA diameter, AAA volume, and ILT volume using three-dimensional ultrasound and 3D-CEUS, respectively. Patients were categorized into blood type O and non-O groups for analysis. ILT volume was compared between the groups. RESULTS:In total, 296 patients under surveillance for AAA with a median AP diameter of 43 [IQR 38-48] mm, and blood type O (N.=101) and non-O (N.=195) were included. Patients with blood type O had a 4.6% lower ILT volume per 10 mL AAA volume than patients with other blood-types (P=0.003), after adjusting for AAA volume and other known covariates. CONCLUSIONS:Blood type O is associated with a lower thrombus load in patients with AAA. This finding aligns with prior evidence linking non-O blood types to elevated vWf and Factor VIII levels, both important in generating thromboses. Future longitudinal studies are needed to explore the relationship between blood type and AAA progression.
BACKGROUND:Accurate measurement of the residual sac after endovascular aortic repair (EVAR) is essential for effective surveillance, guiding detection of complications and decisions regarding reintervention. While two-dimensional ultrasound (2D-US) remains standard-of-care, it is limited by operator variability. Three-dimensional ultrasound (3D-US) with modeling software has demonstrated improved precision but remains resource-intensive. The introduction of three-dimensional Software-Assisted Ultrasound (3D-SAUS) offers an automated, on-cart alternative for more streamlined clinical use. This study compares 3D-SAUS with 2D-US in measuring maximum residual sac diameter in EVAR patients, focusing on variability and clinical applicability. METHODS:Patients previously treated with EVAR and following US-based follow-up were scanned by three or four experienced ultrasound operators. The maximum anterior-posterior residual sac diameter was measured for all patients using 2D-US and 3D-SAUS. Outcomes were median and limits of agreement (LoA) with 95% confidence intervals for both modalities. RESULTS:Fourteen EVAR-treated patients underwent 44 paired 2D-US and 3D-SAUS scans. Median maximum residual sac diameters were 50.0 mm with 2D-US and 50.3 mm with 3D-SAUS. LoA were 3.4 mm for 2D-US and 3.6 mm for 3D-SAUS, with overlapping 95% confidence intervals (2.2-4.6 mm and 2.5-4.7 mm, respectively). The difference in LoA was not statistically significant (P=0.61). Automatic technical success was achieved in 79% of the available 3D scans. CONCLUSIONS:3D-SAUS demonstrated comparable residual sac diameter measurement precision and variability to expert 2D-US in post-EVAR patients. These findings support the potential of 3D-SAUS to enhance reproducibility and standardize ultrasound-based follow-up.
BACKGROUND:Deep vein thrombosis (DVT) remains associated with substantial morbidity despite anticoagulation therapy, with 20-30% experiencing recurrence and up to 50% developing post-thrombotic syndrome (PTS). Statins possess anti-inflammatory properties that may benefit DVT outcomes, but evidence for adjunctive use remains limited. METHODS:We conducted a retrospective cohort study of 255 patients with first-episode proximal DVT diagnosed between January 1st, 2020 and December 31st, 2020, with follow-up through December 31st, 2024. Using multinomial propensity scores, we matched patients 1:1:1 who were receiving rosuvastatin 20 mg (N.=85), rosuvastatin 10 mg (N.=85), or no statin (N.=85) for ≥3 months before DVT diagnosis. All patients received guideline-directed anticoagulation. Primary outcome was composite of DVT recurrence and/or PTS. We used Cox regression for time-to-event analyses and mixed-effects models for biomarker trajectories. RESULTS:After median follow-up of 42 months (IQR 36-48), the primary outcome occurred in 31.8% of rosuvastatin 20-mg group, 38.8% of 10-mg group, and 47.1% of controls (HR=0.67, 95% CI 0.50-0.90, P=0.008 for 20 mg vs. control). Both rosuvastatin groups showed greater reductions in inflammatory markers compared to controls. Complete vein recanalization at 48 months was observed in 74.1%, 65.9%, and 58.8% respectively (overall P=0.045; pairwise 20 mg vs. control P=0.095, Table II). Safety profiles were similar across groups, with no excess bleeding or muscle-related events. CONCLUSIONS:In this hypothesis-generating study, rosuvastatin use was associated with reduced DVT complications, with suggestions of dose-dependent effects. These associations require confirmation in prospective randomized trials before clinical recommendations can be made.
