Graz University of Technology, Institute of Biomechanics, Kronesgasse 5-I, 8010, Graz, Austria; Shanghai East Hospital, Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai, PR China.
Medical University of Graz, Clinical Department of Vascular Surgery, Graz, Austria.
Eur J Vasc Endovasc Surg. 2015 Mar;49(3):262-70. doi: 10.1016/j.ejvs.2014.12.009. Epub 2015 Jan 20.
Maximum aortic diameter is an important measure in rupture prediction of abdominal aortic aneurysms (AAAs). Analyzing the variations of geometrical, material, and biochemical properties with increased AAA diameters advances understanding of the effect of lesion enlargement on patient specific vascular properties.
96 AAA samples were harvested during open surgical aneurysm repair. Geometrical factors such as the maximum intraluminal thrombus (ILT) thickness, wall thickness, and AAA expansion rate were measured. Biaxial extension and peeling tests were performed to characterize the biaxial mechanical responses and to quantify the dissection properties of aneurysmal tissue. Mass fraction analysis quantified the dry weight percentages of elastin and collagen within the AAA wall. Linear regression models were used to correlate geometrical, mechanical, and mass fraction data with maximum AAA diameter.
Both ILT thickness and AAA expansion rate increased and were positively correlated with maximum AAA diameter, while there was a slight increase in wall thickness for AAAs with a larger maximum diameter. For the biaxial mechanical responses, mean peak stretches and maximum tangential moduli in the circumferential and longitudinal axes did not correlate with maximum AAA diameters. However, the quantified energy to propagate tissue dissections within intima-media composites showed a significant inverse correlation with maximum AAA diameter. Elastin content decreased significantly with increasing AAA diameter.
Larger AAA diameters are associated with thicker ILTs, higher AAA expansion rates, and pronounced elastin loss, and may also lead to a higher propensity for tissue dissection and aneurysm rupture.
最大主动脉直径是预测腹主动脉瘤(AAA)破裂的重要指标。分析随着 AAA 直径增大而发生的几何形状、材料和生化特性变化,有助于深入了解病变增大对特定患者血管特性的影响。
在开放性外科动脉瘤修复手术期间,采集了 96 个 AAA 样本。测量了几何因素,如最大腔内血栓(ILT)厚度、壁厚和 AAA 扩张率。进行了双向拉伸和剥离试验,以表征双向力学响应,并量化动脉瘤组织的剥离特性。质量分数分析定量了 AAA 壁内弹性蛋白和胶原的干重百分比。使用线性回归模型将几何、力学和质量分数数据与最大 AAA 直径相关联。
ILT 厚度和 AAA 扩张率均增加,并与最大 AAA 直径呈正相关,而壁厚在最大直径较大的 AAA 中略有增加。对于双向力学响应,周向和长轴的平均峰值拉伸和最大切向模量与最大 AAA 直径不相关。然而,在中膜复合体内传播组织剥离的能量与最大 AAA 直径呈显著负相关。弹性蛋白含量随 AAA 直径的增加而显著下降。
较大的 AAA 直径与较厚的 ILT、更高的 AAA 扩张率和明显的弹性蛋白损失相关,也可能导致更高的组织剥离和动脉瘤破裂倾向。