On the influence of wall calcification and intraluminal thrombus on prediction of abdominal aortic aneurysm rupture

Barrett, Hilary E.; Cunnane, Eoghan M.; Hidayat, Hena; O’Brien, Julie; Moloney, Michael A.; Kavanagh, Eamon G.; Walsh, Michael T.

doi:10.1016/j.jvs.2017.05.086

Cited by 33 publications

(28 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although some scholars believe that artery wall calcification will make aneurysm stronger, we find that calcification was usually confined to a certain part of the wall, which indicates the enhancement of the local stiffness. Some studies also have shown that calcification in some aneurysms increases its rigidity and decreases its elasticity (21). The presence of calcified plaque can decline the compliance of the entire cystic wall.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Higher Volume of Hemorrhage in Ruptured Anterior Circulation Intracranial Aneurysms

Zhang

Liu

et al. 2020

Front. Surg.

View full text Add to dashboard Cite

Purpose: To explore the influencing factors of volume hemorrhage in ruptured anterior circulation aneurysms, so as to identify the characteristics of anterior circulation aneurysms with high volume of hemorrhage, and to provide advice for clinical diagnosis and treatment for those aneurysms. Methods: We retrospectively reviewed 437 cases of ruptured anterior intracranial aneurysms in our center between the years 2012 and 2017. According to the inclusion criteria, a total of 100 qualified patients were screened out. We collected demographic characteristics, environmental exposure, and admission status of enrolled patients. In addition, morphological parameters and location of aneurysms were also included. The semiautomatic threshold method was used to measure the volume of hemorrhage. According to the results, the patients were divided into the group with high blood volume and low blood volume. Univariate and multivariate logistic regression analyses were used to discover the related factors affecting the bleeding volume. Results: In univariable analysis, pulse pressure ( P = 0.014) showed a significant difference at the P < 0.05 test level. In terms of aneurysm morphology, the irregular shape ( P < 0.001), calcification ( P = 0.001), and flow angle ( P = 0.006) showed significant statistical differences between the two groups at the P < 0.01 level ( P < 0.01). Multivariate logistic regression analysis showed that irregular shape (OR = 5.370 P = 0.002 < 0.05), large flow angle (OR = 1.033 P = 0.016 < 0.05), and calcification (OR = 5.460 P = 0.003 < 0.05) were risk factors for volume of hemorrhage in ruptured anterior circulation aneurysms. The influence of hypertension history was at critical state (OR = 2.877 P = 0.051 > 005). Conclusions: According to our analysis results, intracranial anterior circulation aneurysms with irregular shapes, calcifications, and large flow angle are more dangerous. Aneurysms with these characteristics often have a large amount of hemorrhage, requiring timely treatment in clinical practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors for Higher Volume of Hemorrhage in Ruptured Anterior Circulation Intracranial Aneurysms

Zhang

Liu

et al. 2020

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…Increasing evidence suggests, however, that ILT plays important roles in lesion enlargement and possible rupture 1–3 and there is motivation to include predictions of thrombus formation within an overall clinical decision rubric. Notwithstanding many prior studies on the biosolid or biofluid mechanics of ILT in AAAs, both idealized and patient-specific 5–7,11–14 , the pronounced patient-to-patient variability in lesion geometry has delayed general understanding.…”

Section: Discussionmentioning

confidence: 99%

“…Over 75% of these lesions harbor an intraluminal thrombus (ILT) that tends to space-fill the dilated region of the aneurysm without encroaching on the original lumen. Notwithstanding some controversy, increasing evidence suggests that an ILT can play significant roles in the natural history of these lesions 1,2 , including contributions to potentially catastrophic rupture due to the release or activation of proteases that can locally weaken the aneurysmal wall 3,4 . Formation of an ILT depends on many factors, including concentrations of coagulation-associated plasma proteins.…”

Section: Introductionmentioning

confidence: 99%

Strongly Coupled Morphological Features of Aortic Aneurysms Drive Intraluminal Thrombus

Bhagavan

Achille

Humphrey

2018

Sci Rep

View full text Add to dashboard Cite

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.

show abstract

“…However, ILT exhibits significantly different material properties than the in vivo aortic wall. ILT stiffness has been found to be independent of ILT volume and AAA diameter . Although increased ILT is reported to be correlated with reduced mean and peak wall stress, it is also associated with rupture at lower AAA diameter and lower peak wall stress .…”

Section: Limitationsmentioning

confidence: 97%

Pulsatile flow measurements and wall stress distribution in a patient specific abdominal aortic aneurysm phantom

et al. 2018

View full text Add to dashboard Cite

In this study, we develop a physiologic internal pressure and wall stress analysis procedure and apply it to a patient-specific abdominal aortic aneurysm model. Timedependent pressure loading of the inner vessel wall was experimentally measured in a 3D printed aneurysm phantom. The results were used as boundary conditions for finite element calculations of von Mises stresses throughout the AAA model over the cardiac cycle. A nonlinear hyperelastic constitutive law with parameters based on biaxial stress-deformation data from aneurysmal tissue samples was used to describe the mechanical behavior of the aneurysm wall. The internal pressure was found to be fairly spatially uniform (within 10%) over most of the cardiac cycle, but average internal pressure varied by more than a factor of two between systole and diastole. The aneurysm wall stress was highly spatially nonuniform. The highest value of von Mises stress was localized in a small area within the aneurysm bulge and remained in the same place throughout the cardiac cycle, suggesting that this area was the most likely point of rupture. Large variations in wall stress over the cardiac cycle suggest calculations that assume steady flow are a poor approximation for physiological stresses. K E Y W O R D SAAA, abdominal aortic aneurysm, finite element analysis, flow field measurements 2258

show abstract

On the influence of wall calcification and intraluminal thrombus on prediction of abdominal aortic aneurysm rupture

Cited by 33 publications

References 31 publications

Risk Factors for Higher Volume of Hemorrhage in Ruptured Anterior Circulation Intracranial Aneurysms

Risk Factors for Higher Volume of Hemorrhage in Ruptured Anterior Circulation Intracranial Aneurysms

Strongly Coupled Morphological Features of Aortic Aneurysms Drive Intraluminal Thrombus

Pulsatile flow measurements and wall stress distribution in a patient specific abdominal aortic aneurysm phantom

Contact Info

Product

Resources

About