Effects of anatomical characteristics as factors in abdominal aortic aneurysm rupture

Abstract

The aim of this study was to analyze the anatomical characteristics of patients with ruptured abdominal aortic aneurysms (AAAs) using computed tomography (CT) aortography in order to determine the risk factors for rupture.We retrospectively reviewed the CT aortography findings and medical records of patients with ruptured AAAs who underwent CT aortography between February 2002 and December 2014. Age, sex, blood pressure at the time of rupture, treatment methods used for the ruptured AAAs, and treatment outcomes were analyzed. Statistical analyses were performed to determine the association between the maximum aneurysm diameter, which is considered the standard predictor of aneurysm rupture, and anatomical characteristics such as proximal neck diameter, angle between the suprarenal aorta and the aneurysm neck (α angle), angle between the aneurysm neck and aneurysm sac (β angle), and angles between the abdominal aorta and both iliac arteries.Data were reviewed for a total of 36 patients. The mean maximum diameter of AAAs was 76.84 ± 21.08 mm. Multivariate analysis adjusted for age and sex indicated statistical correlations between the α and β angles and maximum aneurysm diameter and between the β angle and iliac artery involvement.Our results suggest that the tortuosity of the aorta tends to be associated with the diameter of AAAs and iliac artery involvement. Investigation of the anatomical characteristics of individual patients using CT aortography is expected to aid in predicting the risk of AAA rupture.

Increased tortuosity of basilar artery might be associated with higher risk of aneurysm development

“…Kim et al in their study [22] also found such correlation. It was shown before for aortic [10] and splenic artery [11] aneurysms. In terms of other cerebral vessels, a similar association was found for ICA [14,23], MCA [12], ACoA [13] and VA [24].…”

“…Such changes in haemodynamics cause vessel wall impairment [8,9], which might lead to aneurysm development. In other studies, higher tortuosity was linked to aortic aneurysm presence and risk of rupture [10], as well as to development of splenic artery aneurysm [11]. In our previous study, we have also proved that aneurysms of the middle cerebral artery (MCA) [12], anterior communicating artery (ACA) [13] and internal carotid artery (ICA) [14] are also linked to its tortuosity.…”

Tortuosity of the Internal Carotid Artery and Its Clinical Significance in the Development of Aneurysms

“…However, we achieved contradictory results for SOAM. Association between higher tortuosity and intracranial aneurysm was shown in terms of BA [14] and VA [16], as well as in terms of the splenic artery [12] and aorta [11]. One of the explanations for such correlation could be changes in hemodynamics caused by increase in tortuosity.…”

“…As tortuosity promotes hemodynamic changes in blood flow, it can lead to the development of aneurysms. Such association was found in terms of the aorta [11] and splenic artery [12], as well as in brain arteries, such as the internal carotid artery (ICA) [13], basilar artery (BA) [14], middle cerebral artery (MCA) [15], and vertebral artery [16]. Our previous study suggested that tortuosity of the anterior cerebral artery might play a role in anterior communicating artery aneurysm rupture [17].…”

Computer-aided analysis of middle cerebral artery tortuosity: association with aneurysm development

“…29 Tortuosity also plays a role in aortic aneurysm analysis. It was proven to be associated with a higher risk of rupture, 25 as well as with higher maximum wall stress. 31 An explanation for the association between higher tortuosity and MCA aneurysm occurrence may be the fact that higher tortuosity is associated with arterial wall weakening.…”