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Aortic 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 Image Added

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)

Image Added

AAA can 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.

Symptoms for TAA are: patients may suffer a local mass effect, such as compression of the trachea or mainstem bronchus (if in the area of the lungs, will cause cough, dyspnea, wheezing, or recurrent pneumonitis), compression of the esophagus (causing dysphagia), or compression of the recurrent laryngeal nerve (causing hoarseness). Chest pain, generally described as deep and aching or throbbing.

Symptoms of AAA are: pain in the chest, abdomen, lower back, or flank (over the kidneys). A pulsating feeling in the abdomen. A "cold foot" or a black or blue painful toe.

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.

Excerpt Include

	TAA and AAA concept map 2
	TAA and AAA concept map 2

When a patient has abdominal aortic aneurysm of a substantial size, the patient may also have synchronous and metachronous thoracic aortic aneurysm. If causes and conditions are present to create an aneurysm in a large-medium size vessel in one place, you are more likely than those without those causes and conditions to have (or develop) another aneurysm somewhere.

Case 1 - Subject has both TAA and AAA

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

Dataset wrap

title	cv.xpt
Name	PR

Dataset2

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

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.

Dataset wrap

title	cv.xpt
Name	cv

Rowcaps

Row 1:	I examined the image of the thoracic

cavity

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

descending aortic aneurysm

aneurysm from aortic arch to the descending aorta (test location).
Row 3:	I examined the image of the thoracic

cavity

region (test location) and found

out

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

cavity

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

cavity

region and found

out

that the infrarenal aorta (result location) had dissected.

Dataset2

Row	STUDYID	DOMAIN	USUBJID	CVSEQ	CVGRPID	CVTEST	CVORRES	CVORRESUCVORRESU	CVLOC	CVLOCDTL	CVMETHOD	VISITNUM	VISIT	CVDTC	CVRESLOC	CVRESLOC Detail
1	ABC	CV	ABC-123	1	1	Aneurysm Indicator	Y		Thoracic Cavityregion		CT SCAN	1	BASELINE	20202020-04-27	Thoracic Aorta	Aortic Arch to Descending aortaDescending Aorta
2	ABC	CV	ABC-123	2	1	Aneurysm Diameter	6	cm	Thoracic Aorta	Aortic Arch to Descending Aortaaorta	CT SCAN	1	BASELINE	20202020-04-27
43	ABC	CV	ABC-123	43	2	Dissection Indicator	Y		Thoracic Cavityregion		CT SCAN	1	BASELINE	20202020-04-27	Descending Aortaaorta
64	ABC	CV	ABC-123	64	2	Stanford AoD Classification	Stanford B		Descending Aortaaorta		CT SCAN	1	BASELINE	20202020-04-27
75	ABC	CV	ABC-123	75	3	Aneurysm Indicator	Y		Abdominal Cavityregion		CT SCAN	1	BASELINE	20202020-04-27	Infrarenal aorta	proximal to the iliac bifurcation
86	ABC	CV	ABC-123	86	3	Aneurysm Diameter	7	cm	Infrarenal aorta	proximal to the iliac bifurcation	CT SCAN	1	BASELINE	20202020-04-27
107	ABC	CV	ABC-123	107		Dissection Indicator	Y		Abdominal Cavityregion		CT SCAN	1	BASELINE	20202020-04-27	Infrarenal aorta	proximal to the iliac bifurcation

Case 2 - Subject has AAA but TAA is not found

The subject had CT scans a MRI performed at the chest and abdomenon the torso (trunk).

Dataset wrap

title	cv.xpt
Name	PR

Dataset2

2

Row	STUDYID	DOMAIN	USUBJID	PRSEQ	PRTRT	PRLOC	VISIT		PRLOC1	PRLOC2
1	ABC	PR	ABC-456	1	CT SCANMRI	CHESTMultiple	BASELINE		Chest	ABC	PR	ABC-456	2	CT SCAN	ABDOMEN	BASELINE	Abdomen

The MRI scan produced images about the thoracic and abdominal regions of the subject. The evaluator then examined the MRI images of the thoracic region and abdominal region, and found the presence of a large AAA, but Modeling the presence of AAA and the absence of TAA in CV.

Dataset wrap

title	cv.xpt
Name	cv

Rowcaps

Row 1:	I examined the MRI image of the thoracic region (test location) and didn't find the presence of an aneurysm.
Row 2:	I examined the MRI image of the abdominal region (test location) and found an aneurysm in the left (Result LAT) renal artery (Result Loc).
Row 3:	I examined the image of the abdominal region (test location) and found an aneurysm in the infrarenal aorta (Result Loc).
Row 4:	I measured the diameter of the aneurysm in the left renal artery (test location).
Row 5:	I measured the diameter of the aneurysm in the Infrarenal Aorta (test location).

Dataset2

Row	STUDYID	DOMAIN	USUBJID	CVSEQ	CVGRPID	CVTEST	CVORRES	CVORRESUCVORRESU	CVLOC	CVLATCVLOCDTL	CVMETHOD	VISITNUM	VISIT	CVDTC		CVRESLAT
1	ABC	CV	ABC-456	1		Aneurysm Indicator	N		Thoracic CavityRegion		CT SCANMRI	1	BASELINE	20202020-04-27
2	ABC	CV	ABC-456	2	1	Aneurysm Indicator	Y	Thoracic Cavity		Abdominal Region		MRICT SCAN	1	BASELINE	20202020-04-27	Renal Artery	Left
3	ABC	CV	ABC-456	3	2	Aneurysm Indicator	Y	Thoracic Cavity		Abdominal Region		MRICT SCAN	1	BASELINE	20202020-04-27	Infrarenal Aorta
54	ABC	CV	ABC-456	54	1	Aneurysm Diameter	23	cm	Renal Artery	Left	CT SCANMRI	1	BASELINE	20202020-04-27
65	ABC	CV	ABC-456	65	2	Aneurysm Diameter	5	cm	Infrarenal Aorta		MRI	1	BASELINE	2020-04-27

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Case 1 - Subject has both TAA and AAA

Case 2 - Subject has AAA but TAA is not found