Aneurysmal Hypertension and its Relationship to Sac Thrombus: A Semi-qualitative Analysis by Experimental Fluid Mechanics

Chaudhuri, Arindam; Ansdell, Leslie E.; Grass, Anthony J.; Adiseshiah, M

doi:10.1016/j.ejvs.2003.11.010

Cited by 14 publications

(5 citation statements)

References 14 publications

(2 reference statements)

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“…On the other hand, there is still some concern regarding the protective role of ILT, since many authors who evaluated in vivo the influence of ILT on intraluminal pressure transmission reported that the presence of ILT fails to reduce the transmission of intraluminal pressure on the AAA wall, consequently leaving the risk of AAA rupture unaffected. 18,19 The above has been reported to hold true even in thrombosed aneurysms. [20][21][22][23][24][25][26] The mechanical properties of ILT that are typically utilized in computational patientspecific AAA models are derived from population mean parameters for ILT material characteristics.…”

Section: Role Of Peak Wall Stress (Pws)mentioning

confidence: 76%

Computational Evaluation of Aortic Aneurysm Rupture Risk: What Have We Learned So Far?

Georgakarakos

Ioannou

Papaharilaou

et al. 2011

Journal of Endovascular Therapy

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In current clinical practice, aneurysm diameter is one of the primary criteria used to decide when to treat a patient with an abdominal aortic aneurysm (AAA). It has been shown that simple association of aneurysm diameter with the probability of rupture is not sufficient, and other parameters may also play a role in causing or predisposing to AAA rupture. Peak wall stress (PWS), intraluminal thrombus (ILT), and AAA wall mechanics are the factors most implicated with rupture risk and have been studied by computational risk evaluation techniques. The objective of this review is to examine these factors that have been found to influence AAA rupture. The prediction rate of rupture among computational models depends on the level of model complexity and the predictive value of the biomechanical parameters used to assess risk, such as PWS, distribution of ILT, wall strength, and the site of rupture. There is a need for simpler geometric analogues, including geometric parameters (e.g., lumen tortuosity and neck length and angulation) that correlate well with PWS, conjugated with clinical risk factors for constructing rupture risk predictive models. Such models should be supported by novel imaging techniques to provide the required patient-specific data and validated through large, prospective clinical trials.

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Section: Role Of Peak Wall Stress (Pws)mentioning

confidence: 76%

Computational Evaluation of Aortic Aneurysm Rupture Risk: What Have We Learned So Far?

Georgakarakos

Ioannou

Papaharilaou

et al. 2011

Journal of Endovascular Therapy

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“…But a glycerol/water mixture has a markedly higher density (1172 kg/m 3 ) than both blood (1060 kg/m 3 ) and water (1000 kg/m 3 ). 19 Since our results suggest that redirection of flow is a more important factor for displacement forces than shear stress, a similar density is more important than a similar viscosity to mimic the in vivo situation. 10 Sideways movement was limited by the stent graft's fixed anchoring to the strain gauge load cells.…”

mentioning

confidence: 70%

Displacement Forces in Iliac Landing Zones and Stent Graft Interconnections in Endovascular Aortic Repair: An Experimental Study

Roos

Ghaffari

Falkenberg

et al. 2014

European Journal of Vascular and Endovascular Surgery

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Pulsatile flow through a tubular untapered stent graft causes forces of similar magnitude at both ends and induces pulsatile graft movements in its unsupported mid-section. Peak forces are close to those previously reported to be required to extract a stent graft. The forces and movements increase with increasing graft angulation and perfusion pressure. Improved anchoring of the distal end of stent grafts may be considered.

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“…On a recent study, Polzer et al [114] have found that ILT fissures locally increase the mechanical stress in the underlying wall up to a 30% which could possibly cause AAA rupture. In addition, in vivo measurements of intraluminal pressure pointed out that the presence of ILT did not significantly reduce the transmission of intraluminal pressure on the AAA wall [115,116]. From a mechanical point of view, ILT is usually considered as a homogeneous incompressible hyperelastic solid [110,117,118].…”

Section: Influence Of Ilt On Peak Wall Stressmentioning

confidence: 99%

Biological, Geometric and Biomechanical Factors Influencing Abdominal Aortic Aneurysm Rupture Risk: A Comprehensive Review

Raut

Chandra

Shum

et al. 2013

RPTMI

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The current clinical management of abdominal aortic aneurysm (AAA) disease is based to a great extent on measuring the aneurysm maximum diameter to decide when timely intervention is required. Decades of clinical evidence show that aneurysm diameter is positively associated with the probability of rupture, but that other parameters may also play a role in causing or predisposing the AAA to rupture. Biological factors associated with smooth muscle apoptosis are implicated in AAA expansion while geometric and biomechanical factors identified by means of computational modeling techniques have been positively correlated with rupture risk with a higher accuracy and sensitivity than maximum diameter alone. The objective of this review is to examine the factors found to influence AAA disease progression, clinical management and rupture, as well as a patent review that highlights developments in this arena in the past few years.

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Aneurysmal Hypertension and its Relationship to Sac Thrombus: A Semi-qualitative Analysis by Experimental Fluid Mechanics

Abstract: Thrombus has a significant effect on the intraaneurysmal lumen itself and causes localised hypertension with high intraluminal pressures. The differences between the sac wall/luminal pressures may affect regional aneurysm wall biomechanics, but needs further study.

Cited by 14 publications

References 14 publications

Computational Evaluation of Aortic Aneurysm Rupture Risk: What Have We Learned So Far?

Computational Evaluation of Aortic Aneurysm Rupture Risk: What Have We Learned So Far?

Displacement Forces in Iliac Landing Zones and Stent Graft Interconnections in Endovascular Aortic Repair: An Experimental Study

Biological, Geometric and Biomechanical Factors Influencing Abdominal Aortic Aneurysm Rupture Risk: A Comprehensive Review

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