Effect of intraluminal thrombus on pressure transmission in the abdominal aortic aneurysm

Abstract

Endovascular aneurysm repair (EVAR) aims at reducing the pressure in the aneurysmal sac. Therefore, it seems attractive to use pressure monitoring in the aneurysmal sac as a follow-up after EVAR. This study contributes to the development of the rationale of pressure monitoring in the aneurysmal sac as a follow-up method after EVAR. The aneurysmal sac is filled with thrombus. To interpret pressure measurements in the thrombus, we have to learn about the effect of the thrombus on pressure transmission and on the pressure measurements themselves. Our study demonstrates that reduction of pressure occurs as it is transmitted through a human aortic thrombus.

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

“…Not considering the poroelastic nature of the ILT is another study limitation. 2,19,31 A recent study reports that including the poroelastic description of a homogeneous ILT does not change the computed arterial wall stress that was predicted with hyperelastic descriptions. 31 However, this conclusion might not be directly applicable to inhomogeneous ILT composition.…”

“…Specifically, ILT can restore the lumen of a distended aorta to a semi-normal size and helps carry blood pressure, i.e., it unloads the underlying wall from stress through a stress-cushioning effect. 4,6,19,24,27,40,43,51 The stresscushioning effect may be compromised in fissured ILTs. 24 However, a thick ILT layer is also known to weaken the underlying AAA wall, 49 and it has also been suggested it increases AAA rupture risk.…”

Predicting Aortic Aneurysm Expansion by PET

“…If the disease continues unchecked, the aneurysm wall becomes thinner and progressively less cellular. Finally, there is often substantial adherent luminal thrombus, variously described as either protective (13)(14)(15) or destabilizing (16) to the aneurysm.…”

Development of fibrinous thrombus analogue for in-vitro abdominal aortic aneurysm studies

“…The human aortic thrombus can reduce the pressure on the aortic wall (Hinnen et al, 2005). So thrombus should be incorporated in the aneurysm model to simulate the in-vivo situation if pressure measurement studies are carried out.…”