The Impact of Intraluminal Thrombus Failure on the Mechanical Stress in the Wall of Abdominal Aortic Aneurysms

Polzer, Stanislav; Gasser, Thomas C.; Swedenborg, Jesper; Burša, Jiří

doi:10.1016/j.ejvs.2010.12.010

Cited by 57 publications

(45 citation statements)

References 30 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, earlier results from our group 35,36 indicated that peak wall stress (PWS) was predominantly located at the ILT-free aneurysm wall, suggesting that, beside the specific ILT morphology (constitution), its topology (geometrical configuration) also considerably influences PWS predictions. This conclusion is in basic agreement with many other studies 15,20,24,27,32,51 that observed a considerable change of wall stress magnitude and distribution when incorporating ILT in a biomechanical analysis.…”

Section: Introductionsupporting

confidence: 94%

“…40,42,49 In addition some studies investigated the effect of ILT on wall stress. 5,10,15,31,32,51 In this regard, Di Martino and Vorp 5 studied the variation of ILT material properties on idealized geometries, but no conclusive studies are available on patient-specific geometries. The present study used 21 patient-specific AAA cases to investigate the impact of ILT mechanical properties and topology on PWS of patient-specific AAA geometries under static conditions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

On the Impact of Intraluminal Thrombus Mechanical Behavior in AAA Passive Mechanics

et al. 2015

View full text Add to dashboard Cite

Intraluminal thrombus (ILT) is a pseudo-tissue that develops from coagulated blood, and is found in most abdominal aortic aneurysms (AAAs) of clinically relevant size. A number of studies have suggested that ILT mechanical characteristics may be related to AAA risk of rupture, even though there is still great controversy in this regard. ILT is isotropic and inhomogeneous and may appear as a soft (single-layered) or stiff (multilayered fibrotic) tissue. This paper aims to investigate how ILT constitution and topology influence the magnitude and location of peak wall stress (PWS). In total 21 patient-specific AAAs (diameter 4.2-5.4 cm) were reconstructed from computer tomography images and biomechanically analyzed using state-of-the-art modeling assumptions. Results indicated that PWS correlated stronger with ILT volume (ρ = 0.44, p = 0.05) and minimum thickness of ILT layer (ρ = 0.73, p = 0.001) than with maximum AAA diameter (ρ = 0.05, p = 0.82). On average PWS was 20% (SD 12%) higher for FE models that used soft instead of stiff ILT models (p < 0.001). PWS location strongly correlated with sites of minimum ILT thickness in the section of maximum AAA diameter and was independent from ILT stiffness. In addition, ILT heterogeneity, i.e., the spatial composition of soft and stiff thrombus tissue, can considerably influence stress in the AAA wall. The present study is limited to identification of influential biomechanical factors, and how its findings translate to an AAA rupture risk assessment remains to be explored by clinical studies.

show abstract

Section: Introductionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

On the Impact of Intraluminal Thrombus Mechanical Behavior in AAA Passive Mechanics

et al. 2015

View full text Add to dashboard Cite

show abstract

“…5 Larger cells like macrophages are more likely to be present in the luminal layers, 6 but can also be found in deeper layers. Another study showed that the canniculi were larger in the abluminal part of the ILT than in the luminal part, 11 which could make it easier for both larger molecules and even cells to reach the AAA wall. The findings in our study support the hypothesis of the leaky ILT and spongy vessel wall that may allow proteases and other unfavorable molecules to build up and degrade wall components ultimately leading to AAA growth.…”

Section: -mentioning

confidence: 99%

“…10 In finite elements simulations using computed tomography angiography scans from AAA patients, cracks and fissures in the ILT increase wall stress on the underlying AAA wall. 11 Differences in ILT composition may result in different quantities and compositions of biologically active proteins accumulating near and in the AAA wall. Likewise, it has been suggested that the sponginess of the arterial wall and its content of plasma and thrombus components may be part of an aneurysm's natural history, hereby determining its growth rate.…”

mentioning

confidence: 99%

Abdominal Aortic Aneurysms Growth Is Associated With High Concentrations of Plasma Proteins in the Intraluminal Thrombus and Diseased Arterial Tissue

Andersen

Lindholt

Urbonavičius

et al. 2018

ATVB

View full text Add to dashboard Cite

Objective-Porosity of the intraluminal thrombus (ILT) is believed to convey biologically active components from the bloodstream toward the aneurismal wall. Accumulation of molecules in the abdominal aortic aneurysmatic tissue may influence vascular protein turnover and regulate abdominal aortic aneurysm growth. We sought to identify proteins with concentrations in the ILT and the abdominal aortic aneurysm wall which associate with aneurysmal expansion rate. Approach and Results-Proteomic analysis by liquid chromatography tandem-mass spectrometry of separated wall and ILT samples was correlated with preoperative aneurysmal growth rate in 24 individuals operated electively for infrarenal abdominal aortic aneurysm. The median preoperative growth rate was 3.8 mm/y (interquartile range, 3) and the mean observational time was 3.3±1.7 years. Plasma components dominated the group of proteins with tissue concentrations, which correlate positively with growth rates (P<0.001, Fisher exact test, both in the ILT and the wall). In contrast, in the wall and thrombus samples, ECM (extracellular matrix) proteins were significantly more prevalent in the group of proteins with negative correlations to growth rates (P<0.05, Fisher exact test). Similarly, a long series of proteins, related to cellular functions correlated negatively to growth rates. Conclusions-When the preoperative aneurysmatic growth rate has been high, the concentration of many plasma proteins residing in the ILT and the aneurysmatic tissue is also high, compatible with the hypothesis of increased tissue porosity and accumulation of plasma components as a driver of aneurysm expansion. Moreover, many matrix and cellular proteins which are found in high concentrations in slower-growing aneurysms provides new knowledge about potential treatment targets. Visual Overview-An online visual overview is available for this article.

show abstract

“…Integration of geometry data with solid modelling is used for estimation of vessel wall distension, strain and stress patterns. Studies, to date, have typically used 3D geometries usually obtained from computer tomography (CT) [52] or MRI [7] scans or have used simplified morphologies [17,62]. Figure 5 reports as example the phases from a CT reconstruction.…”

Section: Geometrical Modelmentioning

confidence: 99%

Biomechanics and FE Modelling of Aneurysm: Review and Advances in Computational Models

Celi¹,

Berti²

2012

Aneurysm

View full text Add to dashboard Cite

The Impact of Intraluminal Thrombus Failure on the Mechanical Stress in the Wall of Abdominal Aortic Aneurysms

Abstract: ILT fissures increase the stress in the underlying wall, whereas regions other than that remain unaffected. If ILT fissures reach the wall or involve large parts of the ILT, the resulting increase in wall stress could possibly cause AAA rupture.

Cited by 57 publications

References 30 publications

On the Impact of Intraluminal Thrombus Mechanical Behavior in AAA Passive Mechanics

On the Impact of Intraluminal Thrombus Mechanical Behavior in AAA Passive Mechanics

Abdominal Aortic Aneurysms Growth Is Associated With High Concentrations of Plasma Proteins in the Intraluminal Thrombus and Diseased Arterial Tissue

Biomechanics and FE Modelling of Aneurysm: Review and Advances in Computational Models

Contact Info

Product

Resources

About