Increased Peak Wall Stress, but Not Maximum Diameter, Is Associated with Symptomatic Abdominal Aortic Aneurysm

Soto, Begoña; Vilá, Luis M.; Dilmé, Jaime Félix; Escudero, José Román; Bellmunt, Sergi; Camacho, Mercedes

doi:10.1016/j.ejvs.2017.09.010

Cited by 21 publications

(12 citation statements)

References 17 publications

(16 reference statements)

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“…Surprisingly, the size of aneurysm was not identified as a risk factor of preoperative anxiety or depression, which might be explained by the fact that increased peak wall stress, but not maximum diameter, is more capable of differentiating symptomatic AAA and asymptomatic AAA. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Preoperative Anxiety and Depression in Patients Scheduled for Abdominal Aortic Aneurysm Repair

Liu

Zhao

et al. 2018

Chinese Medical Journal

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Background:Perioperative emotional disorders of patients underwent abdominal aortic aneurysm (AAA) repair is an emerging area of study, and preoperative mental distress of those patients remains poorly understood. The aim of this study was to investigate the prevalence and identify the risk factors of preoperative anxiety and depression in patients scheduled for AAA repair.Methods:A total of 189 patients who underwent elective AAA repair between 2015 and 2016 were included in this study. These patients were preoperatively evaluated by Hospital Anxiety and Depression Scale (HADS). Demographics and anxiety and depression scores of the patients were documented. Logistic regression was used to identify the independent risk factors of preoperative anxiety and depression.Results:A total of 150 AAA patients were included in final analysis. Of these 150 patients, 44 patients (29.3%) had borderline anxiety or clinical anxiety, and 42 patients (28.0%) were found to have borderline or clinical depression. Female (odds ratio [OR]: 2.81, 95% confidence interval [CI]: 1.08–7.26), the American Society of Anesthesiologists (ASA) Grade 3/4 (OR: 4.34, 95% CI: 1.13–16.68), higher education (OR: 1.44, 95% CI: 1.02–2.04), and abdominal or back pain (OR: 3.08, 95% CI: 1.20–7.87) were identified as significant independent risk factors of abnormal HADS-anxiety in overall patients; and higher level of education (OR: 1.87, 95% CI: 1.16–3.01) was predictive of anxiety in patients planned for endovascular aortic repair. Besides, higher body mass index (BMI) (OR: 1.18, 95% CI: 1.04–1.33) and abdominal or back pain (OR: 3.93, 95% CI: 1.70–9.11) were predictive of abnormal preoperative HADS-depression in overall patients.Conclusion:As for patients scheduled for AAA repair, female, higher ASA, higher level of education, and symptom may be independent risk factors for preoperative anxiety, and symptom and higher BMI may predict preoperative depression.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Preoperative Anxiety and Depression in Patients Scheduled for Abdominal Aortic Aneurysm Repair

Liu

Zhao

et al. 2018

Chinese Medical Journal

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“…Typically, patients with an AAA ≥5.5 cm in MD should be recommended to undergo surgical repair for preventing aneurysm rupture 2 . However, this MD criterion sometimes neglects the potential rupture risk for small AAA (<5.5 cm), and AAA with the same MD does not necessarily have the same propensity for rupture 3 . Thus, additional parameters need to be incorporated in clinical practice to evaluate the stability of AAA.…”

Section: Introductionmentioning

confidence: 99%

“…2 However, this MD criterion sometimes neglects the potential rupture risk for small AAA (<5.5 cm), and AAA with the same MD does not necessarily have the same propensity for rupture. 3 Thus, additional parameters need to be incorporated in clinical practice to evaluate the stability of AAA. From a biomechanical point of view, AAA rupture occurs when the mechanical stress exceeds the tensile strength of the local aortic wall.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Global and Regional Circumferential Strain of Abdominal Aortic Aneurysm with Different Size by Speckle‐Tracking Echocardiography

Liu

Sun

et al. 2021

J of Ultrasound Medicine

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Objectives We aimed to use speckle‐tracking echocardiography (STE) to quantify circumferential aortic strain of abdominal aortic aneurysms (AAA) with different size. Methods A total of 87 AAA patients were included. The morphological variables, including aortic maximum diameter (MD), end systolic area (ESA), end diastolic area (EDA), and thickness and area of intraluminal thrombus (ILT), were measured by ultrasound. STE was applied to calculate circumferential strain (CS) at 6 equally divided segments of the aorta at MD. We evaluated the mean value of peak strain along the 6 segments as global circumferential strain (GCS). Results Large AAA (≥5.5 cm) patients had higher MD, ESA, EDA, AAA length, ILT thickness, and area, but lower fractional area change, GCS, and segmental CSs than small AAA (<5.5 cm) subjects (all P < .05). Compared with AAA <4.5 cm group, AAA patients ≥4.5 cm possessed increased MD, ESA, EDA, AAA length, ILT thickness, and area, which results were also reflected in the comparison between AAA <6.5 and ≥6.5 cm group. In small AAA patients, GCS and regional strains in CS1, CS3, and CS5 segments were lower in AAA subjects ≥4.5 cm than those <4.5 cm (all P<.05). However, no significant differences in the GCS and regional CS between ≥6.5 and <6.5 cm group were found. Correlation analysis revealed a significant negative association of GCS with MD, ESA, and EDA, even after adjusting the potential confounding factors (all P < .05). Conclusions Our findings may yield insight into the structural strain characteristics of AAA wall with different size, which adds the benefit of using simple echocardiography‐derived biomechanics to stratify AAA patients.

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“…Consequently, the diameter-based AAA repair indication is subject to ongoing discussion, which has led to considerable efforts in the search for a more individualized rupture risk assessment. Besides the diameter and its change over time, AAA rupture risk has been related to factors such as biomechanical properties, [11][12][13][14][15][16][17][18] shape, 19 female sex, 11,20,21 family susceptibility, 22 high mean arterial pressure (MAP), 4 smoking, fluorodeoxyglucose uptake on positron emission tomography, 23 thick intraluminal thrombus layer, and fast increase in intraluminal thrombus volume. 24 Although such rupture risk factors are fairly well understood, the quantification of their cumulative effect for an individual patient remains a challenge.…”

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confidence: 99%

Biomechanical indices are more sensitive than diameter in predicting rupture of asymptomatic abdominal aortic aneurysms

Polzer

Gasser

Vlachovský

et al. 2020

Journal of Vascular Surgery

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Increased Peak Wall Stress, but Not Maximum Diameter, Is Associated with Symptomatic Abdominal Aortic Aneurysm

Abstract: This study suggests that MD and the biomechanical parameters obtained by finite element analysis are greater in sAAA than in aAAA. However, considering patients with MD ≥ 65 mm alone, only PWS, and particularly dnPWS, were able to differentiate sAAA from aAAA.

Cited by 21 publications

References 17 publications

Risk Factors for Preoperative Anxiety and Depression in Patients Scheduled for Abdominal Aortic Aneurysm Repair

Risk Factors for Preoperative Anxiety and Depression in Patients Scheduled for Abdominal Aortic Aneurysm Repair

Assessment of the Global and Regional Circumferential Strain of Abdominal Aortic Aneurysm with Different Size by Speckle‐Tracking Echocardiography

Biomechanical indices are more sensitive than diameter in predicting rupture of asymptomatic abdominal aortic aneurysms

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