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Local Diameter, Wall Stress, and Thrombus Thickness Influence the Local Growth of Abdominal Aortic Aneurysms.
Martufi, Giampaolo; Lindquist Liljeqvist, Moritz; Sakalihasan, Natzi; Panuccio, Giuseppe; Hultgren, Rebecka; Roy, Joy; Gasser, T Christian.
Afiliação
  • Martufi G; Department of Civil Engineering, University of Calgary, Alberta, Canada gmartufi@ucalgary.ca.
  • Lindquist Liljeqvist M; Department of Solid Mechanics, Royal Institute of Technology, Stockholm, Sweden.
  • Sakalihasan N; Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
  • Panuccio G; Department of Cardiovascular Surgery, University Hospital of Liege, Belgium.
  • Hultgren R; Division of Vascular and Endovascular Surgery, University of Perugia, Hospital S. M. Misericordia, Perugia, Italy.
  • Roy J; Clinic for Vascular and Endovascular Surgery, Münster University Hospital, Münster, Germany.
  • Gasser TC; Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
J Endovasc Ther ; 23(6): 957-966, 2016 12.
Article em En | MEDLINE | ID: mdl-27412646
PURPOSE: To investigate the influence of the local diameter, the intraluminal thrombus (ILT) thickness, and wall stress on the local growth rate of abdominal aortic aneurysms. METHODS: The infrarenal aortas of 90 asymptomatic abdominal aortic aneurysm (AAA) patients (mean age 70 years; 77 men) were retrospectively reconstructed from at least 2 computed tomography angiography scans (median follow-up of 1 year) and biomechanically analyzed with the finite element method. Each individual AAA model was automatically sliced orthogonally to the lumen centerline and represented by 100 cross sections with corresponding diameters, ILT thicknesses, and wall stresses. The data were grouped according to these parameters for comparison of differences among the variables. RESULTS: Diameter growth was continuously distributed over the entire aneurysm sac, reaching absolute and relative median peaks of 3.06 mm/y and 7.3%/y, respectively. The local growth rate was dependent on the local baseline diameter, the local ILT thickness, and for wall segments not covered by ILT, also on the local wall stress level (all p<0.001). For wall segments that were covered by a thick ILT layer, wall stress did not affect the growth rate (p=0.08). CONCLUSION: Diameter is not only a strong global predictor but also a local predictor of aneurysm growth. In addition, and independent of the diameter, the ILT thickness and wall stress (for the ILT-free wall) also influence the local growth rate. The high stress sensitivity of nondilated aortic walls suggests that wall stress peaks could initiate AAA formation. In contrast, local diameters and ILT thicknesses determine AAA growth for dilated and ILT-covered aortic walls.
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombose / Aneurisma da Aorta Abdominal Tipo de estudo: Prognostic_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: J Endovasc Ther Assunto da revista: ANGIOLOGIA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Canadá
Buscar no Google
Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombose / Aneurisma da Aorta Abdominal Tipo de estudo: Prognostic_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: J Endovasc Ther Assunto da revista: ANGIOLOGIA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Canadá