Advancements in identifying biomechanical determinants for abdominal aortic aneurysm rupture.
Abdominal aortic aneurysms are a common health problem and currently the need for surgical intervention is determined based on maximum diameter and growth rate criteria. Since these universal variables often fail to predict accurately every abdominal aortic aneurysms evolution, there is a considerable effort in the literature for other markers to be identified towards individualized rupture risk estimations and growth rate predictions. To this effort, biomechanical tools have been extensively used since abdominal aortic aneurysm rupture is in fact a material failure of the diseased arterial wall to compensate the stress acting on it. The peak wall stress, the role of the unique geometry of every individual abdominal aortic aneurysm as well as the mechanical properties and the local strength of the degenerated aneurysmal wall, all confer to rupture risk. In this review article, the assessment of these variables through mechanical testing, advanced imaging and computational modeling is reviewed and the clinical perspective is discussed.
Department of Vascular Surgery, University of Crete Medical School, Heraklion, Greece kontopodisn@yahoo.gr.
Nikolaos
N
Kontopodis
Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Greece.
Eleni
E
Metaxa
Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Greece.
Yannis
Y
Papaharilaou
Department of Vascular Surgery, University of Crete Medical School, Heraklion, Greece.
Emmanouil
E
Tavlas
Department of Interventional Radiology, University of Crete Medical School, Heraklion, Greece.
Dimitrios
D
Tsetis
Department of Vascular Surgery, University of Crete Medical School, Heraklion, Greece.
Christos
C
Ioannou
D001012:Aorta, Abdominal / Q000503:physiopathology*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D003661:Decision Support Techniques; D018450:Disease Progression; D004548:Elasticity; D006801:Humans; D008955:Models, Cardiovascular; D012039:Regional Blood Flow; D018570:Risk Assessment; D012307:Risk Factors; D013314:Stress, Mechanical; D059289:Vascular Stiffness
Abdominal aortic aneurysm; biomechanics; peak wall stress; rupture risk; wall properties; wall strength