Aortic Aneurysms as Late Sequelae of Above-Knee Amputation

Vollmar, J; Pauschinger, P.; Paes, E; Henze, Elvira; Friesch, A.

doi:10.1016/s0140-6736(89)92999-1

Cited by 99 publications

(60 citation statements)

References 4 publications

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“…wall shear stress; Hoi et al 2004) and wall stress distribution (Vorp et al 1998;Doyle et al 2009). Asymmetric flow patterns have been associated with the formation of aneurysm in lower limb amputees via asymmetric distribution of wall shear stress (Vollmar et al 1989;Paes et al 1990;Naschitz and Lenger 2008). As expected, in our simulations, damage shapes which were more dispersed resulted in more dilation than localised damage shapes (see Figure 7).…”

Section: Discussionsupporting

confidence: 81%

A finite element model of stress-mediated vascular adaptation: application to abdominal aortic aneurysms

Zeinali‐Davarani

Sheidaei

Baek

2011

Computer Methods in Biomechanics and Biomedical Engineering

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Despite rapid expansion of our knowledge of vascular adaptation, developing patient-specific models of diseased arteries is still an open problem. In this study, we extend existing finite element models of stress-mediated growth and remodelling of arteries to incorporate a medical image-based geometry of a healthy aorta and, then, simulate abdominal aortic aneurysm. Degradation of elastin initiates a local dilatation of the aorta while stress-mediated turnover of collagen and smooth muscle compensates the loss of elastin. Stress distributions and expansion rates during the aneurysm growth are studied for multiple spatial distribution functions of elastin degradation and kinetic parameters. Temporal variations of the degradation function are also investigated with either direct time-dependent degradation or stretch-induced degradation as possible biochemical and biomechanical mechanisms for elastin degradation. The results show that this computational model has the capability to capture the complexities of aneurysm progression due to variations of geometry, extent of damage and stress-mediated turnover as a step towards patient-specific modelling.

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Section: Discussionsupporting

confidence: 81%

A finite element model of stress-mediated vascular adaptation: application to abdominal aortic aneurysms

Zeinali‐Davarani

Sheidaei

Baek

2011

Computer Methods in Biomechanics and Biomedical Engineering

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“…76 Hemodynamic disturbances such as low shear stress and turbulent flow, generally associated with branching or high curvature, contribute to some of the localization of atherosclerosis and aneurysms. 18,77 To optimize blood flow through arterial bifurcations, the branching angle must be very obtuse, and the combined lumen areas of the daughter vessels should be greater than the luminal area of the parent vessel.…”

Section: Role Of Bifurcationsmentioning

confidence: 99%

Site Specificity of Aneurysmal Disease

2010

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“…An interesting example of the hemodynamic effect was noted in a study of leg amputations that resulted in an asymmetric flow pattern at the aortic bifunction and an increased risk of aortic aneurysms. 29 The segments of the aorta also differ in vascular nourishment. Vasa vasorum is quite common in the outer portion of the thoracic aorta, whereas it is very rare in the abdominal aorta.2 Oxygen and nourishment of the abdominal aorta must then come mainly by diffusion from within the lumen.…”

Section: Challenges To the Atherosclerosis Theorymentioning

confidence: 99%

Are aortic aneurysms caused by atherosclerosis?

Reed¹,

Reed²,

Stemmermann³

et al. 1992

Circulation

283

174

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BACKGROUND The emerging controversy concerning the causal role of atherosclerosis in the development of aortic aneurysms was examined using the accumulated clinical and autopsy data obtained during a 20-year follow-up of a cohort of more than 8,000 men of Japanese ancestry in Hawaii. METHODS AND RESULTS Analyses of 174 clinical incident events indicated that there were two types of aneurysmal disease, 151 aortic aneurysms and 23 aortic dissections. The baseline risk factors that predicted the clinical aortic aneurysms were the same factors that predicted aortic atherosclerosis in the same cohort, namely, high blood pressure, high serum cholesterol, and cigarette smoking. These same risk factors were also significantly associated with the occurrence of 27 aortic aneurysms among 293 autopsied men. The less common aortic dissections had an age-specific incidence pattern indicative of an innate susceptibility precipitated by an exposure to another factor. This pattern was consistent with the findings that the incidence of aortic dissections was predicted mainly by baseline high blood pressure. CONCLUSIONS From the perspective of prevention, it appears that the risk factors for aortic atherosclerosis and probably atherosclerosis itself are necessary elements in the causal pathway for the great majority of aortic aneurysms in this cohort.

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Aortic Aneurysms as Late Sequelae of Above-Knee Amputation

Cited by 99 publications

References 4 publications

A finite element model of stress-mediated vascular adaptation: application to abdominal aortic aneurysms

A finite element model of stress-mediated vascular adaptation: application to abdominal aortic aneurysms

Site Specificity of Aneurysmal Disease

Are aortic aneurysms caused by atherosclerosis?

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