An evaluation of new methods of expressing aortic aneurysm size: Relationship to rupture

Ouriel, Kenneth; Green, Richard M.; Donayre, Carlos E.; Shortell, Cynthia K.; Elliott, Janice; DeWeese, James A.

doi:10.1016/0741-5214(92)70008-9

Cited by 178 publications

(97 citation statements)

References 8 publications

(3 reference statements)

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“…This condition is present in Ϸ2% of the elderly population, with Ϸ150 000 new cases diagnosed each year, and the incidence is increasing. 1,2 If left untreated, AAA will gradually expand until rupture; it is an event that carries a mortality rate of 90% and that is ranked as the 13th most common cause of death in the US. 3 Current AAA repair procedures are expensive and carry significant morbidity and mortality risks.…”

mentioning

confidence: 99%

Biomechanical Determinants of Abdominal Aortic Aneurysm Rupture

Vorp

Geest

2005

ATVB

228

172

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Abstract-Rupture of abdominal aortic aneurysm (AAA) represents a significant clinical event, having a mortality rate of 90% and being currently ranked as the 13th leading cause of death in the US. The ability to reliably evaluate the susceptibility of a particular AAA to rupture on a case-specific basis could vastly improve the clinical management of these patients. Because AAA rupture represents a mechanical failure of the degenerated aortic wall, biomechanical considerations are important to understand this process and to improve our predictions of its occurrence. Presented here is an overview of research to date related to the biomechanics of AAA rupture. This includes a summary of results related to ex vivo and in vivo mechanical testing, noninvasive AAA wall stress estimations, and potential mechanisms of AAA wall weakening. We conclude with a demonstration of a biomechanics-based approach to predicting AAA rupture on a patient-specific basis, which may ultimately prove to be superior to the widely and currently used maximum diameter criterion. Key Words: abdominal aortic aneurysm Ⅲ biomechanics Ⅲ rupture Ⅲ strength Ⅲ stress A bdominal aortic aneurysm (AAA) is a focal enlargement of the infrarenal aorta, which occurs over a time course of several years. This condition is present in Ϸ2% of the elderly population, with Ϸ150 000 new cases diagnosed each year, and the incidence is increasing. 1,2 If left untreated, AAA will gradually expand until rupture; it is an event that carries a mortality rate of 90% and that is ranked as the 13th most common cause of death in the US. 3 Current AAA repair procedures are expensive and carry significant morbidity and mortality risks.Open repair of AAA is a major surgical procedure that requires patients to be hospitalized typically for 1 week and to recuperate at home for several more weeks. The mean postoperative mortality for elective repair is Ϸ5% and for emergency operations 47% (range 27% to 69%). 4 The major drawback of open repair is the compromised quality of life after surgery because of postoperative pain, the prolonged recovery period, and the high costs associated with both the surgery and the recovery.An alternative approach that avoids the extensive tissue dissection associated with open repair is the minimally invasive endovascular repair procedure. The potential advantages of endovascular AAA repair include reductions in mortality, morbidity, blood loss, hospital stay, intensive careOriginal

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mentioning

confidence: 99%

Biomechanical Determinants of Abdominal Aortic Aneurysm Rupture

Vorp

Geest

2005

ATVB

228

172

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“…Largest diameter was defined as the longest minor axis of the elliptical vessel in the axial image, which is generally a closer approximation of true maximum aneurysm diameter. 9) The area of aneurysm and the thrombotic area rate were calculated using the same CT slice. The thrombotic area rate was calculated as the ratio of noncontrast to contrast area within the aneurysm.…”

Section: Measurement Of the Aortic Sizementioning

confidence: 99%

Factors for Sac Size Change of Abdominal Aortic Aneurysm after Endovascular Repair

Tsuyuki

Matsushita

Dohi

et al. 2014

ATCS

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Objectives: Factor(s) affecting the sac size of an abdominal aortic aneurysm (AAA) after endovascular aneurysm repair (EVAR) remain unclear. We compared the diameter of the aneurysm sac at one year after surgery with the preoperative diameter using CT images. Methods: Patients who underwent EVAR at Juntendo University Hospital were involved. According to the size change in treated lesions of the aorta, patients were categorized into the following 3 groups: shrink (<5 mm of reduction), enlarge (>5 mm of expansion), and no change (size change within 5 mm). The patients' background, laboratory data, devices used, medications, anatomical characteristics, and presence/absence of postoperative endoleaks were examined. Results: Of the 68 consecutive patients, 23 were excluded. Seventeen patients were classified into the shrink group, 28 patients into the no change group, and no patients into the enlarge group. Patients with higher thrombotic area rate on the preoperative AAA tended to present AAA sac shrinkage (p = 0.05). No other variables affected the size change in this study. In addition, the existence of an endoleak suggested the interference of sac shrinkage. Conclusions: The higher AAA thrombotic area rate tended to associate with AAA sac shrinkage.

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“…Surgical interventions in repairing AAA have significantly developed in recent years 3-6%, reducing causes of death in patients of over 65 years of age, any case when rupture occurs 50% of patients die before reaching hospital [1].…”

Section: Introductionmentioning

confidence: 99%

“…This condition is growing in prevalence in the elderly population, with approximately 150,000 new cases being diagnosed every year [1,2]. An AAA may rupture if it is not treated, and this is ranked as the 13th most common cause of death in the US [3].…”

Section: Introductionmentioning

confidence: 99%