Representation of the various aortic aneurysms in CV

Aneurysms in the aorta are classified based on their anatomical locations. Largely, they can be divided into two classes: thoracic aortic aneurysm (TAA), those that are in the thoracic aorta, and abdominal aortic aneurysm (AAA), those that are in the abdominal aorta.

Aortic aneurysm final

Thoracic aortic aneurysm (TAA) can further be divided into:

Aortic root aneurysm
Ascending aortic aneurysm
Aortic arch aneurysm
Descending aortic aneurysm
Aneurysm that straddles multiple portions of the aorta (i.e. from aortic arch to descending aorta)

Abdominal aortic aneurysm (AAA) can be classified as:

Suprarenal aortic aneurysm: above the kidneys
Infrarenal aortic aneurysm: below the kidneys.
Others: Pararenal, Jaxtarenal aortic aneurys.

Most patients with aortic aneurysms (AA) are asymptomatic at the time of diagnosis, because the aneurysms are typically discovered incidentally on imaging studies. When an AA reaches medium to large size (>5cm), symptoms may manifest.

The patient had undergone a diagnostic intervention, during which a CT scan was done on the chest and abdomen of the subject. The CT scan created images of the thoracic and abdominal regions. An evaluator then reviewed the images of the thoracic region and abdominal region, to find whether aneurysms and arterial dissections are present and where they are located.

TAA and AAA concept map 2

Case 1 - Subject has both TAA and AAA

The subject had CT scans performed on the chest and abdomen.

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pr.xpt

Row	STUDYID	DOMAIN	USUBJID	PRSEQ	PRTRT	PRLOC	VISIT
1	ABC	PR	ABC-123	1	CT SCAN	CHEST	BASELINE
2	ABC	PR	ABC-123	2	CT SCAN	ABDOMEN	BASELINE

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An evaluator examines the images of the thoracic and abdominal regions produced by the CT scan and decides whether TAA and AAA are present as well as their location. Modeling both TAA and AAA in the CV domain, note for viewing simplicity, some variables are omitted from the table below.

Row 1:	I examined the image of the thoracic region (test location) and found an aneurysm in the Thoracic Aorta (result location) spanning from the aortic arch to the descending aorta (result location detail). In this case result location detail further qualifies both ORRES and RESLOC, hence this is a variable qualifier.
Row 2:	I measured the diameter of the aneurysm from aortic arch to the descending aorta (test location).
Row 3:	I examined the image of the thoracic region (test location) and found that the descending aorta (result location) had severely dissected (the artery is tore and a false lumen had formed), most likely due to the enormous pressure caused by the large aneurysm in this area.
Row 4:	The dissected descending aorta (test location) is classified based on the Stanford Aortic Dissection System as type B.
Row 5:	I examined the image of the abdominal region (test location) and found an aneurysm in the infrarenal aorta (result location), proximal to the iliac bifurcation (result location detail). In this case result location detail is a variable qualifier for the result, I am trying to say that the aneurysm is located in the segment of the infrarenal aorta closer (proximal) to the iliac bifurcation.
Row 6:	I measured the diameter of the infrarenal aortic (test location) aneurysm.
Row 7:	I examined the image of the abdominal region and found that the infrarenal aorta (result location) had dissected.

cv.xpt

Row	STUDYID	DOMAIN	USUBJID	CVSEQ	CVGRPID	CVTEST	CVORRES	CVORRESU	CVLOC	CVLOCDTL	CVMETHOD	VISITNUM	VISIT	CVDTC	CVRESLOC	CVRESLOC Detail
1	ABC	CV	ABC-123	1	1	Aneurysm Indicator	Y		Thoracic region		CT SCAN	1	BASELINE	2020-04-27	Thoracic Aorta	Aortic Arch to Descending aorta
2	ABC	CV	ABC-123	2	1	Aneurysm Diameter	6	cm	Thoracic Aorta	Aortic Arch to Descending aorta	CT SCAN	1	BASELINE	2020-04-27
3	ABC	CV	ABC-123	3	2	Dissection Indicator	Y		Thoracic region		CT SCAN	1	BASELINE	2020-04-27	Descending aorta
4	ABC	CV	ABC-123	4	2	Stanford AoD Classification	Stanford B		Descending aorta		CT SCAN	1	BASELINE	2020-04-27
5	ABC	CV	ABC-123	5	3	Aneurysm Indicator	Y		Abdominal region		CT SCAN	1	BASELINE	2020-04-27	Infrarenal aorta	proximal to the iliac bifurcation
6	ABC	CV	ABC-123	6	3	Aneurysm Diameter	7	cm	Infrarenal aorta	proximal to the iliac bifurcation	CT SCAN	1	BASELINE	2020-04-27
7	ABC	CV	ABC-123	7		Dissection Indicator	Y		Abdominal region		CT SCAN	1	BASELINE	2020-04-27	Infrarenal aorta	proximal to the iliac bifurcation

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Case 2 - Subject has AAA but TAA is not found

The subject had a MRI performed on the torso (trunk).