Biomechanical factors in abdominal aortic aneurysm rupture

Inzoli, Fabio; Boschetti, Federica; Zappa, Manuela; Longo, T; Fumero, R.

doi:10.1016/s0950-821x(05)80714-5

Cited by 160 publications

(135 citation statements)

References 9 publications

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“…The results of this work also suggested the possible "mechanical cushioning effect" of the ILT, an observation that has been supported by us and other investigators. 26,27 Sonesson et al investigated the stiffness of the abdominal aorta as well as the common carotid artery in patients with AAA and reported an increase in stiffness for both of these when compared with data reported for healthy subjects. 28 These authors suggest that aneurysmal formation is a system-wide phenomenon with a localized manifestation in the abdominal aortic region.…”

Section: In Vivo Mechanical Evaluationmentioning

confidence: 99%

“…The earliest predictions for AAA wall stress used the Law of LaPlace, 26,[51][52][53] which assumes that the AAA wall geometry is a simple cylinder or sphere with a single radius of curvature. However, the AAA wall is complexly shaped with both major and minor wall curvatures.…”

Section: Estimation Of Aaa Wall Stressmentioning

confidence: 99%

“…Other early mechanical wall stress models for AAA were rather crude, using inappropriate tissue constitutive models, idealized geometries, and/or 2-dimensional stress analyses. 26,48,[51][52][53]57 The use of the theory of linearized elasticity or other inappropriate tissue constitutive models in AAA stress models 26,48,[51][52][53]55,57 can also lead to erroneous stress distribution predictions. 16 Each of the aforementioned approaches, although providing useful information on the general factors influencing AAA wall stress, are unable to provide realistic stress distributions in patient-specific AAA.…”

Section: Estimation Of Aaa Wall Stressmentioning

confidence: 99%

“…However, it has been suggested via idealized geometries and finite element analysis that ILT acts to reduce peak wall stress by up to 30%. 26,48,57 Subsequent research by our laboratory has shown that not including the commonly found ILT into finite element analyses can lead to significant errors in both the magnitude and the distribution of AAA wall stresses 27,58 ( Figure 2). For this reason, our methods now routinely include the ILT.…”

Section: Estimation Of Aaa Wall Stressmentioning

confidence: 99%

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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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Section: In Vivo Mechanical Evaluationmentioning

confidence: 99%

Section: Estimation Of Aaa Wall Stressmentioning

confidence: 99%

Section: Estimation Of Aaa Wall Stressmentioning

confidence: 99%

Section: Estimation Of Aaa Wall Stressmentioning

confidence: 99%

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Biomechanical Determinants of Abdominal Aortic Aneurysm Rupture

Vorp

Geest

2005

ATVB

228

172

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“…Some researchers claim that ILT lowers the rupture risk. This purely mechanical standpoint is derived from computer analysis and assumes that additional layer in AAA has protective effect of reducing the wall stress [19][20][21][22].…”

Section: Presence Of Intraluminal Thrombus and Calcifications In Aaa mentioning

confidence: 99%

Biomechanical factors in Finite Element Analysis of abdominal aortic aneurysms

et al. 2017

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Pathogenesis of abdominal aortic aneurysm

MacSweeney

Powell

Greenhalgh

1994

Journal of British Surgery

182

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The pathogenesis of abdominal aortic aneurysm involves many factors acting over time. However, destruction of elastin in the aortic wall is a key event that shifts the load produced by blood pressure on to collagen. This is exacerbated in the presence of hypertension. Smoking and age are further important factors, as is the site; elastic lamellae are relatively less common in the abdominal aorta. Once the shielding effect of elastin is lost, further dilatation and rupture of the aorta depend on the physical properties of the collagen present.

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Biomechanical factors in abdominal aortic aneurysm rupture

Cited by 160 publications

References 9 publications

Biomechanical Determinants of Abdominal Aortic Aneurysm Rupture

Biomechanical Determinants of Abdominal Aortic Aneurysm Rupture

Biomechanical factors in Finite Element Analysis of abdominal aortic aneurysms

Pathogenesis of abdominal aortic aneurysm

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