Aneurysma aortae abdominalis und Beinamputation: Zufällige Koinzidenz oder pathogenetische Korrelation?

Vollmar, J; Paes, E; Pauschinger, P.; Gross, P

doi:10.1055/s-2008-1067890

Cited by 9 publications

(2 citation statements)

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“…For example, Crawford et al [ 100 ] demonstrated that reductions in aortic outflow from iliac occlusive disease are associated with increased peak wall stress and rupture of AAAs at smaller sizes. These studies are supported by historical data that demonstrated higher AAA rupture rate in patients with surgical ligation of the iliac arteries, which was done in combination axillo-bifemoral bypass as an experimental treatment for AAA, as well as in patients with reduced aortic outflow due to previous lower extremity amputations [ 101 , 102 ]. Moreover, Haller et al [ 103 ] found that increased ILT burden is associate with an increased risk of rupture in small AAAs (<6 cm).…”

Section: Studies and Limitationsmentioning

confidence: 75%

Predictors of Abdominal Aortic Aneurysm Risks

2020

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Computational biomechanics via finite element analysis (FEA) has long promised a means of assessing patient-specific abdominal aortic aneurysm (AAA) rupture risk with greater efficacy than current clinically used size-based criteria. The pursuit stems from the notion that AAA rupture occurs when wall stress exceeds wall strength. Quantification of peak (maximum) wall stress (PWS) has been at the cornerstone of this research, with numerous studies having demonstrated that PWS better differentiates ruptured AAAs from non-ruptured AAAs. In contrast to wall stress models, which have become progressively more sophisticated, there has been relatively little progress in estimating patient-specific wall strength. This is because wall strength cannot be inferred non-invasively, and measurements from excised patient tissues show a large spectrum of wall strength values. In this review, we highlight studies that investigated the relationship between biomechanics and AAA rupture risk. We conclude that combining wall stress and wall strength approximations should provide better estimations of AAA rupture risk. However, before personalized biomechanical AAA risk assessment can become a reality, better methods for estimating patient-specific wall properties or surrogate markers of aortic wall degradation are needed. Artificial intelligence methods can be key in stratifying patients, leading to personalized AAA risk assessment.

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Section: Studies and Limitationsmentioning

confidence: 75%

Predictors of Abdominal Aortic Aneurysm Risks

2020

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“…Increased peripheral vascular resistance resulting in an increased risk of rupture of AAA was reported. 3 Moreover, Crawford and colleagues reported that mean and maximum wall stress was more than doubled with AOO compared with patent aortic outflow. 4 However, the initial symptoms were abdominal pain and back pain, and we could not find any white thrombus.…”

Section: Discussionmentioning

confidence: 99%

Ruptured Abdominal Aortic Aneurysm Complicated with Occlusion of Bilateral Common Iliac Arteries

Fujimoto

Ogawa

Hayashida

et al. 2022

Vasc Endovascular Surg

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We report a case of ruptured abdominal aortic aneurysm complicated with occlusion of bilateral common iliac arteries. A 68-year-old man complained of sudden onset of lower abdominal and back pain. A contrast-enhanced computed tomography showed ruptured abdominal aortic aneurysm of about 80 mm in diameter and a giant retroperitoneal hematoma, as well as occlusion of both common iliac arteries. We performed Y-grafting, concomitant with thrombectomy of both iliac arteries from inside the aneurysm. Postoperative course was uneventful without ischemic findings of the legs and the patient was discharged on the 17th postoperative day.

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Lower-limb amputation, prevalence of abdominal aortic aneurysm and atherosclerotic risk factors

Lorenz

Panitz

Grosse-Furtner

et al. 1994

British Journal of Surgery

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Bayerbches h d e s a m tRetrospective analysis of 545 surgical patients with infrarenal abdominal aortic aneurysm (AAA) identified 5.1 per cent with unilateral lower-limb amputation'. A pathogenic role for the asymmetrical distal aortic flow and counter pulse wave after amputation has been suggested as a cause of aneurysm. A cross-sectional study reported a greater than fivefold increased risk of AAA after unilateral above-knee amputation'. However, the prevalence of aortic aneurysm was rather low in the reference grou of this study compared with that in other p~b1ications~'~and atherosclerotic risk factors were not strictly controlled. A prospective study was therefore carried out on amputees and concurrent controls to clarify the prevalence of AAA, to challenge the local haemdynamic hypothesis of aneurysm formation and to estimate the contribution of atherosclerotic risk factors. Patients and methodsFrom May 1990 to December 1991 all consecutive veterans with lower-limb amputation and a random sample of controls of similar age without amputation presenting to the authors' institutions were studied. A standardized history, physical examination, electrocardiogram, biplanar lumbar radiograph and fasting levels of glucose and lipids wep obtained. The abdominal aorta and iliac arteries were visualized in continuous orthogonal planes by experienced sonographers using a Toshiba VA 100s ultrasonographic scanner (Toshiba. Tokyo, Japan). Aneurysmal dilatation was defined as a maximal luminal diameter greater than 30mm or localized dilatation of the infrared aorta of more than 50 per cent'.Group differences were analysed by Student's t test, the Wilcoxon rank sum test or the x2 test as appropriate. A sample size of 153 was estimated as required to detect a tripling of the estimated 5 per cent prevalence of aneurysm with a power of 90 per cent.

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Aneurysma aortae abdominalis und Beinamputation: Zufällige Koinzidenz oder pathogenetische Korrelation?

Cited by 9 publications

References 0 publications

Predictors of Abdominal Aortic Aneurysm Risks

Predictors of Abdominal Aortic Aneurysm Risks

Ruptured Abdominal Aortic Aneurysm Complicated with Occlusion of Bilateral Common Iliac Arteries

Lower-limb amputation, prevalence of abdominal aortic aneurysm and atherosclerotic risk factors

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