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Aortic Lumen Area I...
Aortic Lumen Area Is Increased in Ruptured Abdominal Aortic Aneurysms and Correlates to Biomechanical Rupture Risk
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- Siika, Antti (författare)
- Karolinska Institutet
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- Liljeqvist, Moritz Lindquist (författare)
- Karolinska Institutet
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- Hultgren, Rebecka (författare)
- Karolinska Institutet
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- Gasser, T. Christian (författare)
- KTH,Hållfasthetslära (Inst.)
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- Roy, Joy (författare)
- Karolinska Institutet
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Karolinska Institutet Hållfasthetslära (Inst) (creator_code:org_t)
- 2018-10-24
- 2018
- Engelska.
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Ingår i: Journal of Endovascular Therapy. - : Sage Publications. - 1526-6028 .- 1545-1550. ; 25:6, s. 750-756
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
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- Purpose: To investigate how 2-dimensional geometric parameters differ between ruptured and asymptomatic abdominal aortic aneurysms (AAAs) and provide a biomechanical explanation for the findings. Methods: The computed tomography angiography (CTA) scans of 30 patients (mean age 77 +/- 10 years; 23 men) with ruptured AAAs and 60 patients (mean age 76 +/- 8 years; 46 men) with asymptomatic AAAs were used to measure maximum sac diameter along the center lumen line, the cross-sectional lumen area, the total vessel area, the intraluminal thrombus (ILT) area, and corresponding volumes. The CTA data were segmented to create 3-dimensional patient-specific models for finite element analysis to compute peak wall stress (PWS) and the peak wall rupture index (PWRI). To reduce confounding from the maximum diameter, 2 diameter-matched groups were selected from the initial patient cohorts: 28 ruptured AAAs and another with 15 intact AAAs (diameters 74 +/- 12 vs 73 +/- 11, p=0.67). A multivariate model including the maximum diameter, the lumen area, and the ILT area of the 60 intact aneurysms was employed to predict biomechanical rupture risk parameters. Results: In the diameter-matched subgroup comparison, ruptured AAAs had a significantly larger cross-sectional lumen area (1954 +/- 1254 vs 1120 +/- 623 mm(2), p=0.023) and lower ILT area ratio (55 +/- 24 vs 68 +/- 24, p=0.037). The ILT area (2836 +/- 1462 vs 2385 +/- 1364 mm(2), p=0.282) and the total vessel area (3956 +/- 1170 vs 4338 +/- 1388 mm(2), p=0.384) did not differ statistically between ruptured and intact aneurysms. The PWRI was increased in ruptured AAAs (0.80 vs 0.48, p<0.001), but the PWS was similar (249 vs 284 kPa, p=0.194). In multivariate regression analysis, lumen area was significantly positively associated with both PWS (p<0.001) and PWRI (p<0.01). The ILT area was also significantly positively associated with PWS (p<0.001) but only weakly with PWRI (p<0.01). The lumen area conferred a higher risk increase in both PWS and PWRI when compared with the ILT area. Conclusion: The lumen area is increased in ruptured AAAs compared to diameter-matched asymptomatic AAAs. Furthermore, this finding may in part be explained by a relationship with biomechanical rupture risk parameters, in which lumen area, irrespective of maximum diameter, increases PWS and PWRI. These observations thus suggest a possible method to improve prediction of rupture risk in AAAs by measuring the lumen area without the use of computational modeling.
Nyckelord
- abdominal aortic aneurysm
- aneurysm diameter
- biomechanics
- computed tomography angiography
- finite element analysis
- intraluminal thrombus
- lumen area
- rupture risk
- ruptured aneurysm
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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