Nikolenko V N, Belov Y V, Oganesyan M V, Efremov Y M, Rizaeva N A, Vovkogon A D, Sankov A V, Gridin L A, Timashev P S, Bulygin K V, Sankova M V
MD, PhD, Professor, Head of the Human Anatomy and Histology Department; I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya St., Moscow, 119991, Russia; Head of the Normal and Topographic Anatomy Department, Fundamental Medicine Faculty; Lomonosov Moscow State University, 1 Leninskiye Gory, Moscow, 119234, Russia.
MD, PhD, Professor, Academician of the Russian Academy of Sciences, Head of the Hospital Surgery Department; I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya St., Moscow, 119991, Russia.
Sovrem Tekhnologii Med. 2024;16(4):46-53. doi: 10.17691/stm2024.16.4.05. Epub 2024 Aug 30.
was to investigate the potential of direct mechanical testing methods in clinical practice to assess the strength and elastic-deformative characteristics of intraoperative samples of aortic arch aneurysm caused by uncontrolled arterial hypertension.
The study experimental material was the resected parts of the aortic aneurysm obtained during aneurysm replacement surgery in a patient with uncontrolled arterial hypertension. The direct mechanical testing methods such as instrumental indentation and uniaxial extension were used.
It was shown that by the direct instrumental indentation it is possible to accurately assess and compare the stiffness of all three layers of the aortic wall. In this clinical case, the inner aorta layer was subject to the greatest atherosclerotic damage. In the media area, the values of this indicator were widely scattered, whereas the material was greatly dissected. By uniaxial extension method it is possible to obtain accurate parameters of the vascular wall strength, as well as to assess the stiffness, elasticity, and deformability of the intraoperatively resected aortic tissue. It was found that the aneurysm aortic wall, compared with the non-dilated aortic section, was characterized by a significantly lower strength in both longitudinal (by 4.25 times) and transverse (by 3.75 times) directions. In addition, aneurysm tissues demonstrated a significantly lower elasticity and deformability.
The study demonstrated the perspectives and options of using in clinical practice current methods of direct mechanical testing, which makes it possible to obtain more accurate indicators of the strength and elastic-deformative vascular characteristics, to clarify the pathophysiological mechanisms of cardiovascular accidents, and to justify the need for regular monitoring of vascular wall stiffness in clinical practice, in particular in patients with uncontrolled arterial hypertension.
旨在研究临床实践中直接机械测试方法评估由未控制的动脉高血压引起的主动脉弓动脉瘤术中样本的强度和弹性变形特征的潜力。
研究的实验材料是在一名患有未控制的动脉高血压患者的动脉瘤置换手术中获得的主动脉瘤切除部分。使用了诸如仪器压痕和单轴拉伸等直接机械测试方法。
结果表明，通过直接仪器压痕可以准确评估和比较主动脉壁所有三层的硬度。在该临床病例中，主动脉内层受到的动脉粥样硬化损伤最大。在中膜区域，该指标的值分布广泛，且材料严重剥离。通过单轴拉伸方法可以获得血管壁强度的准确参数，以及评估术中切除的主动脉组织的硬度、弹性和可变形性。发现与未扩张的主动脉段相比，动脉瘤主动脉壁在纵向（降低4.25倍）和横向（降低3.75倍）方向上的强度均显著降低。此外，动脉瘤组织的弹性和可变形性明显较低。
该研究证明了在临床实践中使用当前直接机械测试方法的前景和选择，这使得有可能获得更准确的血管强度和弹性变形特征指标，阐明心血管意外的病理生理机制，并证明在临床实践中定期监测血管壁硬度的必要性，特别是在患有未控制的动脉高血压患者中。
