PURPOSE

To test the hypothesis that ruptured abdominal aortic aneurysms (AAA) are globally weaker than unruptured ones.

METHODS

Four ruptured and seven unruptured AAA specimens were harvested whole from fresh cadavers during autopsies performed over an 18-month period. Multiple regionally distributed longitudinally oriented rectangular strips were cut from each AAA specimen for a total of 77 specimen strips. Strips were subjected to uniaxial extension until failure. Sections from approximately the strongest and weakest specimen strips were studied histologically and histochemically. From the load-extension data, failure tension, failure stress and failure strain were calculated. Rupture site characteristics such as location, arc length of rupture and orientation of rupture were also documented.

RESULTS

The failure tension, a measure of the tissue mechanical caliber was remarkably similar between ruptured and unruptured AAA (group mean ± standard deviation of within-subject means: 11.2±2.3 versus 11.6±3.6N/cm; p=0.866 by mixed model ANOVA). In post-hoc analysis, there was little difference between the groups in other measures of tissue mechanical caliber as well such as failure stress (95±28 versus 98±23 N/cm(2); p=0.870), failure strain (0.39±0.09 versus 0.36±0.09; p=0.705), wall thickness (1.7±0.4 versus 1.5±0.4mm; p=0.470) , and % coverage of collagen within tissue cross section (49.6±12.9% versus 60.8±9.6%; p=0.133). In the four ruptured AAA, primary rupture sites were on the lateral quadrants (two on left; one on left-posterior; one on right). Remarkably, all rupture lines had a longitudinal orientation and ranged from 1 to 6 cm in length.

CONCLUSION

The findings are not consistent with the hypothesis that ruptured aortic aneurysms are globally weaker than unruptured ones.