Giannoglou Georgios, Giannakoulas Georgios, Hatzitolios Apostolos I, Rudolf Jobst
Kardiologische Klinik I, Aristoteles-Universität, AHEPA-Krankenhaus, Thessaloniki, Griechenland.
Herz. 2008 Jul;33(5):354-61. doi: 10.1007/s00059-008-3067-7. Epub 2008 Sep 5.
Until today, there is no reliable criterion to predict the risk of rupture of abdominal aortic aneurysms (AAAs), which could help in the final clinical decision. The acceptance of the traditional diameter criterion has led to unnecessary surgical procedures with the subsequent high mortality and morbidity. On the other hand, small aneurysms are known that sometimes are subject to rupture, which could be avoided in the case of an early surgical decision. Thus, it becomes necessary to find new criteria, which can reliably predict the actual risk of rupture of AAAs in the clinical setting. This prediction will certainly be a useful clinical tool in the management of patients with AAAs. According to the biomechanical approach in predicting the risk of aneurysm rupture and to the fundamental principles in cardiovascular mechanics, rupture occurs when the AAA wall stresses exceed the failure strength of the wall. Therefore, it becomes obvious that the knowledge of the distribution of stress on a particular AAA wall would be a good indication of its susceptibility to rupture. A methodology to noninvasively determine the in vivo distribution of stresses on the AAA wall is therefore necessary.
直到今天，还没有可靠的标准来预测腹主动脉瘤（AAA）破裂的风险，而这有助于做出最终的临床决策。传统直径标准的采用导致了不必要的外科手术，随之而来的是高死亡率和高发病率。另一方面，已知小动脉瘤有时也会破裂，如果能尽早做出手术决策，这种情况是可以避免的。因此，有必要找到新的标准，以便在临床环境中可靠地预测AAA破裂的实际风险。这种预测无疑将成为管理AAA患者的一种有用的临床工具。根据预测动脉瘤破裂风险的生物力学方法以及心血管力学的基本原理，当AAA壁应力超过壁的破坏强度时就会发生破裂。因此，很明显，了解特定AAA壁上的应力分布将是其破裂易感性的一个很好的指标。因此，需要一种非侵入性方法来确定AAA壁上应力的体内分布。
