The Role of Geometric and Biomechanical Factors in Abdominal Aortic Aneurysm Rupture Risk Assessment

Overview

Journal Ann Biomed Eng

Specialty Biomedical Engineering

Date 2013 Mar 20

PMID 23508633

Citations 29

Authors

Samarth S Raut

Santanu Chandra

Judy Shum

Ender A Finol

Affiliations

Soon will be listed here.

Abstract

The current clinical management of abdominal aortic aneurysm (AAA) disease is based to a great extent on measuring the aneurysm maximum diameter to decide when timely intervention is required. Decades of clinical evidence show that aneurysm diameter is positively associated with the risk of rupture, but other parameters may also play a role in causing or predisposing the AAA to rupture. Geometric factors such as vessel tortuosity, intraluminal thrombus volume, and wall surface area are implicated in the differentiation of ruptured and unruptured AAAs. Biomechanical factors identified by means of computational modeling techniques, such as peak wall stress, have been positively correlated with rupture risk with a higher accuracy and sensitivity than maximum diameter alone. The objective of this review is to examine these factors, which are found to influence AAA disease progression, clinical management and rupture potential, as well as to highlight on-going research by our group in aneurysm modeling and rupture risk assessment.

Citing Articles

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References

Scotti C, Shkolnik A, Muluk S, Finol E . Fluid-structure interaction in abdominal aortic aneurysms: effects of asymmetry and wall thickness. Biomed Eng Online. 2005; 4:64. PMC: 1298313. DOI: 10.1186/1475-925X-4-64. View

Rissland P, Alemu Y, Einav S, Ricotta J, Bluestein D . Abdominal aortic aneurysm risk of rupture: patient-specific FSI simulations using anisotropic model. J Biomech Eng. 2009; 131(3):031001. DOI: 10.1115/1.3005200. View

Baek S, Rajagopal K, Humphrey J . A theoretical model of enlarging intracranial fusiform aneurysms. J Biomech Eng. 2006; 128(1):142-9. DOI: 10.1115/1.2132374. View

Leung J, Wright A, Cheshire N, Crane J, Thom S, Hughes A . Fluid structure interaction of patient specific abdominal aortic aneurysms: a comparison with solid stress models. Biomed Eng Online. 2006; 5:33. PMC: 1488849. DOI: 10.1186/1475-925X-5-33. View

Scotti C, Jimenez J, Muluk S, Finol E . Wall stress and flow dynamics in abdominal aortic aneurysms: finite element analysis vs. fluid-structure interaction. Comput Methods Biomech Biomed Engin. 2008; 11(3):301-22. DOI: 10.1080/10255840701827412. View

Sakalihasan N, Limet R, Defawe O . Abdominal aortic aneurysm. Lancet. 2005; 365(9470):1577-89. DOI: 10.1016/S0140-6736(05)66459-8. View

Mower W, Baraff L, Sneyd J . Stress distributions in vascular aneurysms: factors affecting risk of aneurysm rupture. J Surg Res. 1993; 55(2):155-61. DOI: 10.1006/jsre.1993.1123. View

Vorp D, Raghavan M, Webster M . Mechanical wall stress in abdominal aortic aneurysm: influence of diameter and asymmetry. J Vasc Surg. 1998; 27(4):632-9. DOI: 10.1016/s0741-5214(98)70227-7. View

Chaikof E, Brewster D, Dalman R, Makaroun M, Illig K, Sicard G . The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. J Vasc Surg. 2009; 50(4 Suppl):S2-49. DOI: 10.1016/j.jvs.2009.07.002. View

10.

Doyle B, Callanan A, Burke P, Grace P, Walsh M, Vorp D . Vessel asymmetry as an additional diagnostic tool in the assessment of abdominal aortic aneurysms. J Vasc Surg. 2008; 49(2):443-54. PMC: 2666821. DOI: 10.1016/j.jvs.2008.08.064. View

11.

Di Martino E, Guadagni G, Fumero A, Ballerini G, Spirito R, Biglioli P . Fluid-structure interaction within realistic three-dimensional models of the aneurysmatic aorta as a guidance to assess the risk of rupture of the aneurysm. Med Eng Phys. 2002; 23(9):647-55. DOI: 10.1016/s1350-4533(01)00093-5. View

12.

Xenos M, Rambhia S, Alemu Y, Einav S, Labropoulos N, Tassiopoulos A . Patient-based abdominal aortic aneurysm rupture risk prediction with fluid structure interaction modeling. Ann Biomed Eng. 2010; 38(11):3323-37. DOI: 10.1007/s10439-010-0094-3. View

13.

Michel J, Martin-Ventura J, Egido J, Sakalihasan N, Treska V, Lindholt J . Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans. Cardiovasc Res. 2010; 90(1):18-27. PMC: 3058728. DOI: 10.1093/cvr/cvq337. View

14.

Pappu S, Dardik A, Tagare H, Gusberg R . Beyond fusiform and saccular: a novel quantitative tortuosity index may help classify aneurysm shape and predict aneurysm rupture potential. Ann Vasc Surg. 2007; 22(1):88-97. DOI: 10.1016/j.avsg.2007.09.004. View

15.

Kazi M, Thyberg J, Religa P, Roy J, Eriksson P, Hedin U . Influence of intraluminal thrombus on structural and cellular composition of abdominal aortic aneurysm wall. J Vasc Surg. 2003; 38(6):1283-92. DOI: 10.1016/s0741-5214(03)00791-2. View

16.

Giannoglou G, Giannakoulas G, Soulis J, Chatzizisis Y, Perdikides T, Melas N . Predicting the risk of rupture of abdominal aortic aneurysms by utilizing various geometrical parameters: revisiting the diameter criterion. Angiology. 2006; 57(4):487-94. DOI: 10.1177/0003319706290741. View

17.

Fillinger M, Raghavan M, Marra S, Cronenwett J, Kennedy F . In vivo analysis of mechanical wall stress and abdominal aortic aneurysm rupture risk. J Vasc Surg. 2002; 36(3):589-97. DOI: 10.1067/mva.2002.125478. View

18.

Maier A, Gee M, Reeps C, Pongratz J, Eckstein H, Wall W . A comparison of diameter, wall stress, and rupture potential index for abdominal aortic aneurysm rupture risk prediction. Ann Biomed Eng. 2010; 38(10):3124-34. DOI: 10.1007/s10439-010-0067-6. View

19.

Heng M, Fagan M, Collier J, Desai G, McCollum P, Chetter I . Peak wall stress measurement in elective and acute abdominal aortic aneurysms. J Vasc Surg. 2007; 47(1):17-22. DOI: 10.1016/j.jvs.2007.09.002. View

20.

Gasser T, Ogden R, Holzapfel G . Hyperelastic modelling of arterial layers with distributed collagen fibre orientations. J R Soc Interface. 2006; 3(6):15-35. PMC: 1618483. DOI: 10.1098/rsif.2005.0073. View