Aortic dissection detection and thrombus structure quantification using volumetric ultrasound, histology, and scanning electron microscopy

Luke E Schepers; Irina N Chernysh; Claudia K Albrecht; Luke C Browning; McKenna L Hillsdon-Smith; Abigail D Cox; John W Weisel; Craig J Goergen

doi:10.1016/j.jvssci.2023.100105

Aortic dissection detection and thrombus structure quantification using volumetric ultrasound, histology, and scanning electron microscopy

JVS Vasc Sci. 2023 Mar 31:4:100105. doi: 10.1016/j.jvssci.2023.100105. eCollection 2023.

Authors

Luke E Schepers¹, Irina N Chernysh², Claudia K Albrecht¹, Luke C Browning¹, McKenna L Hillsdon-Smith¹, Abigail D Cox³, John W Weisel², Craig J Goergen¹

Affiliations

¹ Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN.
² University of Pennsylvania School of Medicine, Department of Cell and Developmental Biology, Philadelphia, PA.
³ Department of Comparative Pathobiology, Purdue University, West Lafayette, PA.

Abstract

Aortic dissection occurs when a weakened portion of the intima tears, and a separation of layers propagates along the aortic wall to form a false lumen filled with active blood flow or intramural thrombus. The unpredictable nature of aortic dissection formation and need for immediate intervention leaves limited serial human image data to study the formation and morphological changes that follow dissection. We used volumetric ultrasound examination, histology, and scanning electron microscopy (SEM) to examine intramural thrombi at well-defined timepoints after dissection occurs in apolipoprotein E-deficient mice infused with angiotensin II (n = 71). Stratification of red blood cell (RBC) morphologies (biconcave, intermediate biconcave, intermediate polyhedrocyte, and polyhedrocyte) in the thrombi with scanning electron microscopy (n = 5) was used to determine degree of thrombus deposition/contraction. Very few biconcave RBCs (1.2 ± 0.6%) were in the thrombi, and greater amounts of intermediate biconcave RBCs (25.8 ± 6.7%) were located in the descending thoracic portion of the dissection while more polyhedrocytes (14.6 ± 5.1%) and fibrin (42.3 ± 4.5%; P < .05) were found in the distal suprarenal aorta. Thrombus deposition likely plays some role in patient outcomes, and this multimodality technique can help investigate thrombus deposition and characteristics in experimental animal models and human tissue samples.

Keywords: Aortic dissection; Intramural thrombus formation; Scanning electron microscopy.