Intraluminal thrombus effect on the progression of abdominal aortic aneurysms by using a multistate continuous-time Markov chain model

Liangliang Zhang, Byron A. Zambrano, Jongeun Choi, Whal Lee, Seungik Baek, Chae Young Lim

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Objective: To investigate the relationship between the characteristics of intraluminal thrombus (ILT) with abdominal aortic aneurysm (AAA) expansion. Methods: This retrospective clinical study applied homogeneous multistate continuous-time Markov chain models to longitudinal computed tomography (CT) data from Korean patients with AAA. Four AAA states were considered (early, mild, severe, fatal) and the maximal thickness of the ILT (maxILT), the fraction of the wall area covered by the ILT (areafrac) and the fraction of ILT volume (volfrac) were used as covariates. Results: The analysis reviewed longitudinal CT images from 26 patients. Based on likelihood-ratio statistics, the areafrac was the most significant biomarker and maxILT was the second most significant. In addition, within AAAs that developed an ILT layer, the analysis found that the AAA expands relatively quickly during the early stage but the rate of expansion reduces once the AAA has reached a larger size. Conclusion: The results recommend surgical intervention when a patient has an areafrac more than 60%. Although this recommendation should be considered with caution given the limited sample size, physicians can use the proposed model as a tool to find such recommendations with their own data.

Original languageEnglish
JournalJournal of International Medical Research
Issue number11
Publication statusPublished - 2020

Bibliographical note

Funding Information:
The authors gratefully acknowledge the support, in part, of the National Heart, Lung, and Blood Institute of the National Institutes of Health (no. R01HL115185 and no. R21HL113857) and the National Science Foundation (no. CMMI-1150376). Choi and Lim were supported, in part, by National Research Foundation of Korea grants funded by the Government of South Korea (no. 2018R1A4A1025986 and no. 2019R1A2C1002213).

Publisher Copyright:
© The Author(s) 2020.

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Biochemistry, medical
  • Cell Biology


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