Failure properties of abdominal aortic aneurysm tissue are orientation dependent

Polzer, Stanislav; Man, Vojtěch; Vlachovský, Robert; Kubíček, Luboš; Kracík, Jan; Staffa, Robert; Novotný, Tomáš; Burša, Jiří; Raghavan, Madhavan L.

doi:10.1016/j.jmbbm.2020.104181

Cited by 13 publications

(9 citation statements)

References 29 publications

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“…The thickness of the aorta is spatially inhomogeneous [42][43][44] and the wall thickness of a AAA negatively correlates with the thickness of the underlying ILT layer, 21,27 a factor that is important for successful discrimination of intact and ruptured AAAs. 45 Whilst the wall stress is inversely proportional to the wall thickness, a thinner wall in intact AAAs has a higher strength, 27,58,153 factors that compete with one another. Modelers that consider an inhomogeneous wall thickness should at the same time also prescribe an inhomogeneous wall strength in order to adequately reflect rupture risk.…”

Section: Effect Of Wall Thicknessmentioning

confidence: 99%

“…The review of experimental data showed the dependence of wall strength on PWS, a factor that has been used to refine the design of the PRRI. 62 Wall strength and wall thickness are inversely related, 27,55,58 and so it is of benefit that the joint probability distribution P PWS, σ ult ð Þbe used in the calculation of a probabilistic rupture risk index. Additional approaches towards a more refined computation of the probabilistic rupture risk have included the variability of the blood pressure.…”

Section: Stochastic Modelsmentioning

confidence: 99%

“…Finite deformation models, calibrated to mean population data, determine the biomechanical properties of vessel wall and the intra-luminal thrombus. Analysis performed with A4clinicsRE (Vascops GmbH) and took approximately 10 min on a standard Laptop computer AAA, abdominal aortic aneurysm; CT-A, computed tomography-angiography performed with samples either aligned along the circumferential, 27,[47][48][49] axial, 44,[50][51][52][53][54][55][56][57] or both 51,58,59 directions. The individual layers of the aneurysmal wall have rarely been characterized.…”

Section: Experimental Tissue Characterization and Its Relation To Aaa...mentioning

confidence: 99%

“…In contrast, a recent study adjusted for inter-patient variability and demonstrated that the mean strength in the circumferential direction is approximately 400 kPa higher when compared to the axial strength of the aneurysmatic aorta. 58 The majority of AAA ruptures appear perpendicular to the circumferential direction. 44,51 The rupture defect then materializes longitudinally, as a consequence of the circumferential stress in the wall.…”

Section: Experimental Tissue Characterization and Its Relation To Aaa...mentioning

confidence: 99%

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A quarter of a century biomechanical rupture risk assessment of abdominal aortic aneurysms. Achievements, clinical relevance, and ongoing developments

Gasser

Miller

Polzer

et al. 2022

Numer Methods Biomed Eng

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Abdominal aortic aneurysm (AAA) disease, the local enlargement of the infrarenal aorta, is a serious condition that causes many deaths, especially in men exceeding 65 years of age. Over the past quarter of a century, computational biomechanical models have been developed towards the assessment of AAA risk of rupture, technology that is now on the verge of being integrated within the clinical decision-making process. The modeling of AAA requires a holistic understanding of the clinical problem, in order to set appropriate modeling assumptions and to draw sound conclusions from the simulation results. In this article we summarize and critically discuss the proposed modeling approaches and report the outcome of clinical validation studies for a number of biomechanics-based rupture risk indices. Whilst most of the aspects concerning computational mechanics have already been settled, it is the exploration of the failure properties of the AAA wall and the acquisition of robust input data for simulations that has the greatest potential for the further improvement of this technology. K E Y W O R D Sabdominal aortic aneurysm, modeling, ruptuer risk assessment, vascular biomechanics | WHAT IS AAAWhilst an aneurysm, a permanent local enlargement of an artery by more than 50% of its diameter, may affect all arteries, the infrarenal aorta is most vulnerable to this disease and often leads to the development of an abdominal aortic aneurysm (AAA). The formation of AAAs is promoted by factors such as old age, male gender, smoking, and high mean arterial pressure (MAP). Furthermore, it is over-represented in persons with a family history of AAA and patients with coronary heart disease and Chronic Obstructive Pulmonary Disease. Aortic aneurysms can also present in patients with rare genetic diseases, such as Ehlers-Danlos syndrome type IV, Marfan syndrome, Loeys-Dietz syndrome, and fibromuscular dysplasia. Most AAAs remain small and therefore do not necessitate clinical intervention. However, an aneurysm may grow to a size that could result in aortic rupture, a life-threatening event. In urban areas only 50% of

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Section: Effect Of Wall Thicknessmentioning

confidence: 99%

Section: Stochastic Modelsmentioning

confidence: 99%

Section: Experimental Tissue Characterization and Its Relation To Aaa...mentioning

confidence: 99%

Section: Experimental Tissue Characterization and Its Relation To Aaa...mentioning

confidence: 99%

See 2 more Smart Citations

A quarter of a century biomechanical rupture risk assessment of abdominal aortic aneurysms. Achievements, clinical relevance, and ongoing developments

Gasser

Miller

Polzer

et al. 2022

Numer Methods Biomed Eng

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show abstract

“…Although these values can be compared only qualitatively, the systematic shift caused by using a measurement method generating some (often undefined) contact pressure is obvious. Differences in wall thickness estimation are one of the major sources of differences between reported mechanical responses (both elastic and failure) of soft tissues 15,28 .…”

Section: Discussionmentioning

confidence: 99%

Methodology for estimation of undeformed thickness of arterial tissues

Schwarz

Fleisman

Vitásek

et al. 2023

Sci Rep

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Soft tissue sample thickness measurement is one of the major sources of differences between mechanical responses published by different groups. New method for the estimation of unloaded sample thickness of soft tissues is proposed in this study. Ten 30 × 30 mm and ten 20 × 20 mm samples of porcine anterior thoracic aortas were loaded by gradually increased radial force. Their deformed thickness was then recorded in order to generate a pressure-thickness response. Next, the limit pressure to which the response can be considered linear was estimated. Line was fitted to the linear part of the curve and extrapolated towards zero pressure to estimate unloaded thickness (7 kPa fit). For comparison, data near zero pressure were fitted separately and extrapolated towards zero (Near Zero fit). The limit pressure for the linearity of the response was around 7 kPa. The Unloaded thickness for 30 × 30 mm samples was 2.68 ± 0.31 mm and 2.68 ± 0.3 mm for Near Zero fit and 7 kPa fit, respectively. The Unloaded thickness for 20 × 20 mm samples was 2.60 ± 0.35 mm and 2.59 ± 0.35 mm for Near Zero fit and 7 kPa fit, respectively. The median of thickness difference between smaller and larger samples was not found statistically different. Proposed method can estimate unloaded undeformed sample thickness quickly and reliably.

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Conduit Vessels

Gasser

2021

Vascular Biomechanics

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Failure properties of abdominal aortic aneurysm tissue are orientation dependent

Cited by 13 publications

References 29 publications

A quarter of a century biomechanical rupture risk assessment of abdominal aortic aneurysms. Achievements, clinical relevance, and ongoing developments

A quarter of a century biomechanical rupture risk assessment of abdominal aortic aneurysms. Achievements, clinical relevance, and ongoing developments

Methodology for estimation of undeformed thickness of arterial tissues

Conduit Vessels

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