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Biomechanical Analysis of Abdominal Aortic Aneurysms

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Patient-Specific Modeling of the Cardiovascular System

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Abstract

The aorta is the largest artery in the human body, transporting oxygenized blood directly from the left ventricle of the heart to the rest of the body. An aortic aneurysm is a local dilation in the aorta of more than 1.5 times the original diameter [27]. Although aneurysms can be present in every part of the aorta, the majority of the aortic aneurysms are situated in the abdominal aorta (AAA, Fig. 6.1), below the level of the renal arteries and above the aortic bifurcation to the common iliac arteries [7]. A diameter of 3 cm or more is generally used as indication for an AAA (abdominal aortic aneurysm). In most AAAs, thrombus is found between the perfused flow lumen and the aortic wall. Thrombus is a fibrin structure with mainly blood cells, platelets, and blood proteins, which is deposited onto the vessel wall [21].

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References

  1. Adolph, R., Vorp, D.A., Steed, D.L., Webster, M.W., Kameneva, M.V., Watkins, S.C.: Cellular content and permeability of intraluminal thrombus in abdominal aortic aneurysm. J. Vasc. Surg. 25(5), 916–926 (1997)

    Article  PubMed  CAS  Google Scholar 

  2. Ashton, J.H., vande Geest, J.P., Simon, B.R., Haskett, D.G.: Compressive mechanical properties of the intraluminal thrombus in abdominal aortic aneurysms and fibrin-based thrombus mimics. J. Biomech. 42(3), 197–201 (2009)

    Article  PubMed  Google Scholar 

  3. Basnyat, P.S., Biffin, A.H., Moseley, L.G., Hedges, A.R., Lewis, M.H.: Mortality from ruptured abdominal aortic aneurysm in Wales. Br. J. Surg. 86(6), 765–770 (1999)

    Article  PubMed  CAS  Google Scholar 

  4. Boschetti, F., di Martino, E., Gioda, G.: A poroviscoelastic model of intraluminal thrombus from abdominal aortic aneurysms. Proceedings of the 2007 Summer Bioengineering Conference, Keystone CO (2007)

    Google Scholar 

  5. Bown, M.J., Sutton, A.J., Bell, P.R., Sayers, R.D.: A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair. Br. J. Surg. 89(6), 714–730 (2002)

    Article  PubMed  CAS  Google Scholar 

  6. Breeuwer, M., de Putter, S., Kose, U., Speelman, L., Visser, K., Gerritsen, F., Hoogeveen, R., Krams, R., van den Bosch, H., Buth, J., Gunther, T., Wolters, B., van Dam, E., van de Vosse, F.: Towards patient-specific risk assessment of abdominal aortic aneurysm. Med. Biol. Eng. Comput. 46(11), 1085–1095 (2008)

    Article  PubMed  CAS  Google Scholar 

  7. Crawford, E.S., Cohen, E.S.: Aortic aneurysm: a multifocal disease. Arch. Surg. 117(11), 1393–1400 (1982)

    Article  PubMed  CAS  Google Scholar 

  8. Darling, R.C., Messina, C.R., Brewster, D.C., Ottinger, L.W.: Autopsy study of unoperated abdominal aortic aneurysms. The case for early resection. Circulation 56(Suppl 3), II161–II164 (1977)

    Google Scholar 

  9. de Putter, S., van de Vosse, F.N., Breeuwer, M., Gerritsen, F.A.: Local influence of calcifications on the wall mechanics of abdominal aortic aneurysm. Prog. Biomed. Opt. Imaging 7(2), 61432E.1–61432E.11 (2006)

    Google Scholar 

  10. de Putter, S., Wolters, B.J., Rutten, M.C., Breeuwer, M., Gerritsen, F.A., van de Vosse, F.N.: Patient-specific initial wall stress in abdominal aortic aneurysms with a backward incremental method. J. Biomech. 40(5), 1081–1090 (2007)

    Article  PubMed  Google Scholar 

  11. Delingette, H.: Modélisation, déformation et reconnaissance d’objets tridimensionnels a l’aide de maillages simplexes. Ph.D. thesis, Ecole Centrale de Paris (1994)

    Google Scholar 

  12. Domanovits, H., Schillinger, M., Mullner, M., Holzenbein, T., Janata, K., Bayegan, K., Laggner, A.N.: Acute phase reactants in patients with abdominal aortic aneurysm. Atherosclerosis 163(2), 297–302 (2002)

    Article  PubMed  CAS  Google Scholar 

  13. Eckstein, H.H., Bockler, D., Flessenkamper, I., Schmitz-Rixen, T., Debus, S., Lang, W.: Ultrasonographic screening for the detection of abdominal aortic aneurysms. Dtsch. Arztebl. Int. 206(41), 657–663 (2009)

    Google Scholar 

  14. Engstrom, G., Borner, G., Lindblad, B., Janzon, L., Lindgarde, F.: Incidence of fatal or repaired abdominal aortic aneurysm in relation to inflammation-sensitive plasma proteins. Arterioscler. Thromb. Vasc. Biol. 24(2), 337–341 (2004)

    Article  PubMed  Google Scholar 

  15. Fillinger, M.F., Raghavan, M.L., Marra, S.P., Cronenwett, J.L., Kennedy, F.E.: In vivo analysis of mechanical wall stress and abdominal aortic aneurysm rupture risk. J. Vasc. Surg. 36(3), 589–597 (2002)

    Article  PubMed  Google Scholar 

  16. Gérard, O., Billon, A.C., Rouet, J.M., Jacob, M., Fradkin, M., Allouche, C.: Efficient model-based quantification of left ventricular function in 3-d echocardiography. IEEE Trans. Med. Imaging 21(9), 1059–1068 (2002)

    Article  Google Scholar 

  17. Golledge, J., Tsao, P.S., Dalman, R.L., Norman, P.E.: Circulating markers of abdominal aortic aneurysm presence and progression. Circulation 118(23), 2382–2392 (2008)

    Article  PubMed  Google Scholar 

  18. Greenhalgh, R.M., Brown, L.C., Kwong, G.P., Powell, J.T., Thompson, S.G.: Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 364(9437), 843–848 (2004)

    Article  PubMed  CAS  Google Scholar 

  19. Greenhalgh, R.M., Forbes, J.F., Fowkes, F.G., Powel, J.T., Ruckley, C.V., Brady, A.R., Brown, L.C., Thompson, S.G.: Early elective open surgical repair of small abdominal aortic aneurysms is not recommended: results of the UK small aneurysm trial. Eur. J. Vasc. Endovasc. Surg. 16(6), 462–464 (1998)

    Article  PubMed  CAS  Google Scholar 

  20. Hans, S.S., Jareunpoon, O., Balasubramaniam, M., Zelenock, G.B.: Size and location of thrombus in intact and ruptured abdominal aortic aneurysms. J. Vasc. Surg. 41(4), 584–588 (2005)

    Article  PubMed  Google Scholar 

  21. Harter, L.P., Gross, B.H., Callen, P.W., Barth, R.A.: Ultrasonic evaluation of abdominal aortic thrombus. J. Ultrasound Med. 1(8), 315–318 (1982)

    PubMed  CAS  Google Scholar 

  22. Hellenthal, F.A., Geenen, I.L., Teijink, J.A., Heeneman, S., Schurink, G.W.: Histological features of human abdominal aortic aneurysm are not related to clinical characteristics. Cardiovasc. Pathol. 18(5), 286–293 (2008)

    Article  PubMed  Google Scholar 

  23. Heng, M.S., Fagan, M.J., Collier, J.W., Desai, G., McCollum, P.T., Chetter, I.C.: Peak wall stress measurement in elective and acute abdominal aortic aneurysms. J. Vasc. Surg. 47(1), 17–22 (2008)

    Article  PubMed  Google Scholar 

  24. Hinnen, J.W., Rixen, D.J., Koning, O.H., van Bockel, J.H., Hamming, J.F.: Development of fibrinous thrombus analogue for in-vitro abdominal aortic aneurysm studies. J. Biomech. 40(2), 289–295 (2007)

    Article  PubMed  CAS  Google Scholar 

  25. Hua, J., Mower, W.R.: Simple geometric characteristics fail to reliably predict abdominal aortic aneurysm wall stresses. J. Vasc. Surg. 34(2), 308–315 (2001)

    Article  PubMed  CAS  Google Scholar 

  26. Johnston, K.W.: Ruptured abdominal aortic aneurysm: six-year follow-up results of a multicenter prospective study. J. Vasc. Surg. 19(5), 888–900 (1994)

    Article  PubMed  CAS  Google Scholar 

  27. Johnston, K.W., Rutherford, R.B., Tilson, M.D., Shah, D.M., Hollier, L., Stanley, J.C.: Suggested standards for reporting on arterial aneurysms. J. Vasc. Surg. 13(3), 452–458 (1991)

    Article  PubMed  CAS  Google Scholar 

  28. Kim, L.G., Ra, P.S., Ashton, H.A., Thompson, S.G.: A sustained mortality benefit from screening for abdominal aortic aneurysm. Ann. Intern. Med. 146(10), 699–706 (2007)

    PubMed  Google Scholar 

  29. Kurvers, H., Veith, F.J., Lipsitz, E.C., Ohki, T., Gargiulo, N.J., Cayne, N.S., Suggs, W.D., Timaran, C.H., Kwon, G.Y., Rhee, S.J., Santiago, C.: Discontinuous, staccato growth of abdominal aortic aneurysms. J. Am. Coll. Surg. 199(5), 709–715 (2004)

    Article  PubMed  Google Scholar 

  30. Lederle, F.A., Johnson, G.R., Wilson, S.E., Ballard, D.J., Jordan, W.D., Blebea, J., Littooy, F.N., Freischlag, J.A., Bandyk, D., Rapp, J.H., Salam, A.A.: Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA 287(22), 2968–2972 (2002)

    Article  PubMed  Google Scholar 

  31. Lederle, F.A., Johnson, G.R., Wilson, S.E., Chute, E.P., Littooy, F.N., Bandyk, D., Krupski, W.C., Barone, G.W., Acher, C.W., Ballard, D.J.: Prevalence and associations of abdominal aortic aneurysm detected through screening. Ann. Intern. Med. 126(6), 441–449 (1997)

    PubMed  CAS  Google Scholar 

  32. Lindholt, J.S., Vammen, S., Fasting, H., Henneberg, E.W., Heickendorff, L.: The plasma level of matrix metalloproteinase 9 may predict the natural history of small abdominal aortic aneurysms. A preliminary study. Eur. J. Vasc. Endovasc. Surg. 20(3), 281–285 (2000)

    Article  PubMed  CAS  Google Scholar 

  33. Lovegrove, R.E., Javid, M., Magee, T.R., Galland, R.B.: A meta-analysis of 21,178 patients undergoing open or endovascular repair of abdominal aortic aneurysm. Br. J. Surg. 95(6), 677–684 (2008)

    Article  PubMed  CAS  Google Scholar 

  34. Merkx, M.A., van’t Veer, M., Breeuwer, M., Bosboom, E.M., van de Vosse, F.N.: Importance of initial stress incorporation in abdominal aortic aneurysm wall motion: dynamic MRI validated finite element analysis. J. Biomech. 42(14), 2369–2373 (2009)

    Article  PubMed  CAS  Google Scholar 

  35. Nakamura, M., Tachieda, R., Niinuma, H., Ohira, A., Endoh, S., Hiramori, K., Makita, S.: Circulating biochemical marker levels of collagen metabolism are abnormal in patients with abdominal aortic aneurysm. Angiology 51(5), 385–392 (2000)

    Article  PubMed  CAS  Google Scholar 

  36. Ollabarriaga, S.D., Rouet, J.M., Fradkin, M., Breeuwer, M., Niessen, W.J.: Segmentation of thrombus in abdominal aortic aneurysms from CTA with non-parametric statistical grey level appearance modeling. IEEE Trans Med Imaging 24(4), 477–485 (2005)

    Article  Google Scholar 

  37. Papaharilaou, Y., Ekaterinaris, J.A., Manousaki, E., Katsamouris, A.N.: A decoupled fluid structure approach for estimating wall stress in abdominal aortic aneurysms. J. Biomech. 40(2), 367–377 (2007)

    Article  PubMed  Google Scholar 

  38. Pleumeekers, H.J., Hoes, A.W., van der Does, E., van Urk, H., Hofman, A., de Jong, P.T., Grobbee, D.E.: Aneurysms of the abdominal aorta in older adults. The Rotterdam study. Am. J. Epidemiol. 142(12), 1291–1299 (1995)

    PubMed  CAS  Google Scholar 

  39. Raghavan, M.L., Kratzberg, J., de Tolosa, E.M.C., Hanaoka, M.M., Walker, P., da Silva, E.S.: Regional distribution of wall thickness and failure properties of human abdominal aortic aneurysm. J. Biomech. 39(16), 3010–3016 (2006)

    Article  PubMed  Google Scholar 

  40. Raghavan, M.L., Vorp, D.A.: Toward a biomechanical tool to evaluate rupture potential of abdominal aortic aneurysm: identification of a finite strain constitutive model and evaluation of its applicability. J. Biomech. 33(4), 475–482 (2000)

    Article  PubMed  CAS  Google Scholar 

  41. Sandford, R.M., Bown, M.J., Sayers, R.D., Fishwick, G., London, N.J., Nasim, A.: Endovascular abdominal aortic aneurysm repair: 5-year follow-up results. Ann. Vasc. Surg. 22(3), 372–378 (2008)

    Article  PubMed  CAS  Google Scholar 

  42. Speelman, L., Bosboom, E.M., Schurink, G.W., Buth, J., Breeuwer, M., Jacobs, M.J., van de Vosse, F.N.: Initial stress and nonlinear material behavior in patient-specific AAA wall stress analysis. J. Biomech. 42(11), 1713–1719 (2009)

    Article  PubMed  CAS  Google Scholar 

  43. Speelman, L., Bosboom, E.M., Schurink, G.W., Hellenthal, F.A., Buth, J., Breeuwer, M., Jacobs, M.J., van de Vosse, F.N.: Patient-specific AAA wall stress analysis: 99-percentile versus peak stress. Eur. J. Vasc. Endovasc. Surg. 36(6), 668–676 (2008)

    Article  PubMed  CAS  Google Scholar 

  44. Speelman, L., Hellenthal, F.A., Pulinx, B., Bosboom, E.M., van de Vosse, F.N., Jacobs, M.J., Breeuwer, M., van Sambeek, M.J.H.M., Wodzig, W.K.W.H., Schurink, G.W.: The influence of wall stress on AAA growth and biomarkers. Eur. J. Vasc. Endovasc. Surg. 39(4), 410–416 (2010)

    Article  PubMed  CAS  Google Scholar 

  45. Speelman, L., Schurink, G.W., Bosboom, E.M., Buth, J., Breeuwer, M., van de Vosse, F.N., Jacobs, M.J.: The mechanical role of thrombus on the growth rate of an AAA. J. Vasc. Surg. 51(1), 19–26 (2010)

    Article  PubMed  Google Scholar 

  46. Stonebridge, P.A., Draper, T., Kelman, J., Howlett, J., Allan, P.L., Prescott, R., Ruckley, C.V.: Growth rate of infrarenal aortic aneurysms. Eur. J. Vasc. Endovasc. Surg. 11(1), 70–73 (1996)

    Article  PubMed  CAS  Google Scholar 

  47. Thanos, J., Rebeira, M., Shragge, B.W., Urbach, D.: Vascular ultrasound screening for asymptomatic abdominal aortic aneurysm. Healthc. Policy 4(2), 75–83 (2008)

    PubMed  Google Scholar 

  48. Truijers, M., Fillinger, M.F., Renema, K.W., Marra, S.P., Oostveen, L.J., Kurvers, H.A., Schultzekool, L.J., Blankensteijn, J.D.: In-vivo changes in abdominal aortic aneurysm thrombus volume during the cardiac cycle. J. Endovasc. Ther. 16, 314–319 (2009)

    Article  PubMed  Google Scholar 

  49. Truijers, M., Pol, J.A., Schultzekool, L.J., van Sterkenburg, S.M., Fillinger, M.F., Blankensteijn, J.D.: Wall stress analysis in small asymptomatic, symptomatic and ruptured abdominal aortic aneurysms. Eur. J. Vasc. Endovasc. Surg. 33(4), 401–407 (2007)

    Article  PubMed  CAS  Google Scholar 

  50. Urbonavicius, S., Urbonaviciene, G., Honore, B., Henneberg, E.W., Vorum, H., Lindholt, J.S.: Potential circulating biomarkers for abdominal aortic aneurysm expansion and rupture – a systematic review. Eur. J. Vasc. Endovasc. Surg. 36(3), 273–280 (2008)

    Article  PubMed  CAS  Google Scholar 

  51. Vainas, T., Lubbers, T., Stassen, F.R., Herngreen, S.B., Dieijen-Visser, M.P., Bruggeman, C.A., Kitslaar, P.J., Schurink, G.W.: Serum C-reactive protein level is associated with abdominal aortic aneurysm size and may be produced by aneurysmal tissue. Circulation 107(8), 1103–1105 (2003)

    Article  PubMed  Google Scholar 

  52. van Dam, E.A., Dams, S.D., Peters, G.W., Rutten, M.C., Schurink, G.W., Buth, J., van de Vosse, F.N.: Non-linear viscoelastic behavior of abdominal aortic aneurysm thrombus. Biomech. Model. Mechanobiol. 7(2), 127–137 (2008)

    Article  PubMed  Google Scholar 

  53. van’t Veer, M., Buth, J., Merkx, M., Tonino, P., van den Bosch, H., Pijls, N., van de Vosse, F.N.: Biomechanical properties of abdominal aortic aneurysms assessed by simultaneously measured pressure and volume changes in humans. J. Vasc. Surg. 48, 1401–1407 (2008)

    Article  Google Scholar 

  54. vande Geest, J.P., di Martino, E.S., Bohra, A., Makaroun, M.S., Vorp, D.A.: A biomechanics-based rupture potential index for abdominal aortic aneurysm risk assessment: demonstrative application. Ann. N. Y. Acad. Sci. 1085, 11–21 (2006)

    Article  Google Scholar 

  55. vande Geest, J.P., Wang, D.H., Wisniewski, S.R., Makaroun, M.S., Vorp, D.A.: Towards a noninvasive method for determination of patient-specific wall strength distribution in abdominal aortic aneurysms. Ann. Biomed. Eng. 34(7), 1098–1106 (2006)

    Article  Google Scholar 

  56. Vega de Céniga, M., Esteban, M., Quintana, J.M., Barba, A., Estallo, L., de la Fuente, N., Viviens, B., Martin-Ventura, J.L.: Search for serum biomarkers associated with abdominal aortic aneurysm growth – a pilot study. Eur. J. Vasc. Endovasc. Surg. 37(3), 297–299 (2009)

    Article  Google Scholar 

  57. Vega de Céniga, M., Gomez, R., Estallo, L., de la Fuente, N., Viviens, B., Barba, A.: Analysis of expansion patterns in 4–4.9 cm abdominal aortic aneurysms. Ann. Vasc. Surg. 22(1), 37–44 (2008)

    Article  Google Scholar 

  58. Vega de Céniga, M., Gomez, R., Estallo, L., Rodriguez, L., Baquer, M., Barba, A.: Growth rate and associated factors in small abdominal aortic aneurysms. Eur. J. Vasc. Endovasc. Surg. 31(3), 231–236 (2006)

    Article  Google Scholar 

  59. Venkatasubramaniam, A.K., Fagan, M.J., Mehta, T., Mylankal, K.J., Ray, B., Kuhan, G., Chetter, I.C., McCollum, P.T.: A comparative study of aortic wall stress using finite element analysis for ruptured and non-ruptured abdominal aortic aneurysms. Eur. J. Vasc. Endovasc. Surg. 28(2), 168–176 (2004)

    PubMed  CAS  Google Scholar 

  60. Vorp, D.A., Lee, P.C., Wang, D.H., Makaroun, M.S., Nemoto, E.M., Ogawa, S., Webster, M.W.: Association of intraluminal thrombus in abdominal aortic aneurysm with local hypoxia and wall weakening. J. Vasc. Surg. 34(2), 291–299 (2001)

    Article  PubMed  CAS  Google Scholar 

  61. Wang, D.H., Makaroun, M.S., Webster, M.W., Vorp, D.A.: Mechanical properties and microstructure of intraluminal thrombus from abdominal aortic aneurysm. J. Biomech. Eng. 123(6), 536–539 (2001)

    Article  PubMed  CAS  Google Scholar 

  62. Wilson, W.R., Anderton, M., Choke, E.C., Dawson, J., Loftus, I.M., Thompson, M.M.: Elevated plasma mmp1 and mmp9 are associated with abdominal aortic aneurysm rupture. Eur. J. Vasc. Endovasc. Surg. 35(5), 580–584 (2008)

    Article  PubMed  CAS  Google Scholar 

  63. Wolf, Y.G., Thomas, W.S., Brennan, F.J., Goff, W.G., Sise, M.J., Bernstein, E.F.: Computed tomography scanning findings associated with rapid expansion of abdominal aortic aneurysms. J. Vasc. Surg. 20(4), 529–535 (1994)

    Article  PubMed  CAS  Google Scholar 

  64. Wolters, B.J., Emmer, M., Rutten, M.C., Schurink, G.W., van de Vosse, F.N.: Assessment of endoleak significance after endovascular repair of abdominal aortic aneurysms: a lumped parameter model. Med. Eng. Phys. 29(10), 1106–1118 (2007)

    Article  PubMed  CAS  Google Scholar 

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  1. Biomechanics Laboratory, Department of Biomedical Engineering, Erasmus Medical Center Rotterdam, 2040, Ee2322, 3000 CA, Rotterdam, The Netherlands

    Lambert Speelman

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  1. Dept. Bioengineering, University of California, San Diego, 9500 Gillman Drive, La Jolla, 92093, California, USA

    Roy C.P. Kerckhoffs

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Speelman, L., Bosboom, M., Schurink, G.W.H., v.d. Vosse, F.N. (2010). Biomechanical Analysis of Abdominal Aortic Aneurysms. In: Kerckhoffs, R. (eds) Patient-Specific Modeling of the Cardiovascular System. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6691-9_6

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