Aortic outflow occlusion predicts rupture of abdominal aortic aneurysm

Crawford, Jeffrey D.; Chivukula, Venkat Keshav; Haller, Stephen J.; Vatankhah, Nasibeh; Bohannan, Colin J.; Moneta, Gregory L.; Rugonyi, Sandra; Azarbal, Amir F.

doi:10.1016/j.jvs.2016.03.454

Cited by 30 publications

(15 citation statements)

References 14 publications

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“…20 Vollmar et al reported a 5.1 fold higher prevalence of AAA in World War II amputees versus nonamputated veterans, speculating on aneurysm bulging and appositional luminal thrombus, 21 whereas Crawford et al reported AAA rupture depending on aortic outlfow. 16 With the flow modulated PPE, it has been shown in the present study that mimicking impaired aortic outflow by iliac or distal aortic stenosis increases AAA diameter significantly, with aneurysms bulging to the contralateral side, and has different effects on the circumference of the aortic wall (Fig. 2B).…”

Section: Discussionsupporting

confidence: 51%

Four Surgical Modifications to the Classic Elastase Perfusion Aneurysm Model Enable Haemodynamic Alterations and Extended Elastase Perfusion

Busch

Chernogubova

Jin

et al. 2018

European Journal of Vascular and Endovascular Surgery

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Section: Discussionsupporting

confidence: 51%

Four Surgical Modifications to the Classic Elastase Perfusion Aneurysm Model Enable Haemodynamic Alterations and Extended Elastase Perfusion

Busch

Chernogubova

Jin

et al. 2018

European Journal of Vascular and Endovascular Surgery

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“…We have previously identified peripheral arterial disease and aortic outflow occlusion as surrogate markers for increased PWS, decreased aortic wall strength, and features of early AAA rupture. 20 Our objective in this study was to explore the association between ILT and risk of AAA rupture, particularly in small aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Intraluminal thrombus is associated with early rupture of abdominal aortic aneurysm

Haller

Crawford

Courchaine

et al. 2018

Journal of Vascular Surgery

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This study found that although increased ILT is associated with lower MWS and PWS, it is also associated with aneurysm rupture at smaller diameters and lower stress. Therefore, the protective biomechanical advantage that ILT provides by lowering wall stress seems to be outweighed by weakening of the AAA wall, particularly in patients with small rAAAs. This study suggests that high ILT burden may be a surrogate marker of decreased aortic wall strength and a characteristic of high-risk small aneurysms.

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“…1), the degree and direction of bulging of the aneurysm from the natural curvature of the infrarenal aorta, the angle of the iliac bifurcation, and the presence of an extra renal artery (which manifests in approximately one third of all cases) 20 could be considered. There is similarly a need to consider possible effects of peripheral vessel disease, such as stenosis or occlusion, and effects of spinal cord injury or lower limb amputation, all of which can adversely affect AAA hemodynamics 21–23 . Such simulations were simply beyond the present scope, particularly noting that one would need to appropriately adjust outlet conditions to account for remodeling of the contralateral iliac/femoral in cases of unilateral disease or amputation, hence increasing the parametric space considerably.…”

Section: Discussionmentioning

confidence: 99%

Strongly Coupled Morphological Features of Aortic Aneurysms Drive Intraluminal Thrombus

Bhagavan

Achille

Humphrey

2018

Sci Rep

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Over 75% of abdominal aortic aneurysms harbor an intraluminal thrombus, and increasing evidence suggests that biologically active thrombus contributes to the natural history of these potentially lethal lesions. Thrombus formation depends on the local hemodynamics, which in turn depends on morphological features of the aneurysm and near vasculature. We previously presented a hemodynamically motivated “thrombus formation potential” that predicts where and when thrombus might form. Herein, we combine detailed studies of the three-dimensional hemodynamics with methods of sparse grid collocation and interpolation via kriging to examine roles of five key morphological features of aneurysms on thrombus formation: lesion diameter, axial position, length, curvature, and renal artery position. Computational simulations suggest that maximum diameter is a key determinant of thrombogenicity, but other morphological features modulate this dependence. More distally located lesions tend to have a higher thrombus formation potential and shorter lesions tend to have a higher potential than longer lesions, given the same aneurysmal dilatation. Finally, movement of vortical structures through the infrarenal aorta and lesion can significantly affect thrombogenicity. Formation of intraluminal thrombus within an evolving abdominal aortic aneurysm thus depends on coupled morphological features, not all intuitive, and computational simulations can be useful for predicting thrombogenesis.

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Aortic outflow occlusion predicts rupture of abdominal aortic aneurysm

Cited by 30 publications

References 14 publications

Four Surgical Modifications to the Classic Elastase Perfusion Aneurysm Model Enable Haemodynamic Alterations and Extended Elastase Perfusion

Four Surgical Modifications to the Classic Elastase Perfusion Aneurysm Model Enable Haemodynamic Alterations and Extended Elastase Perfusion

Intraluminal thrombus is associated with early rupture of abdominal aortic aneurysm

Strongly Coupled Morphological Features of Aortic Aneurysms Drive Intraluminal Thrombus

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