Review: The Role of Biomechanical Modeling in the Rupture Risk Assessment for Abdominal Aortic Aneurysms

2013 ◽  
Vol 135 (2) ◽  
Author(s):  
Giampaolo Martufi ◽  
T. Christian Gasser
Keyword(s):  
Risk Assessment ◽  
Vascular Tissue ◽  
Vascular Wall ◽  
Aortic Aneurysms ◽  
Test Case ◽  
Rupture Risk ◽  
Biomechanical Simulation ◽  
Abdominal Aortic ◽  
Case Simulation

AAA disease is a serious condition and a multidisciplinary approach including biomechanics is needed to better understand and more effectively treat this disease. A rupture risk assessment is central to the management of AAA patients, and biomechanical simulation is a powerful tool to assist clinical decisions. Central to such a simulation approach is a need for robust and physiologically relevant models. Vascular tissue senses and responds actively to changes in its mechanical environment, a crucial tissue property that might also improve the biomechanical AAA rupture risk assessment. Specifically, constitutive modeling should not only focus on the (passive) interaction of structural components within the vascular wall, but also how cells dynamically maintain such a structure. In this article, after specifying the objectives of an AAA rupture risk assessment, the histology and mechanical properties of AAA tissue, with emphasis on the wall, are reviewed. Then a histomechanical constitutive description of the AAA wall is introduced that specifically accounts for collagen turnover. A test case simulation clearly emphasizes the need for constitutive descriptions that remodels with respect to the mechanical loading state. Finally, remarks regarding modeling of realistic clinical problems and possible future trends conclude the article.

scholarly journals Additional value of biomechanical indices based on CTa for rupture risk assessment of abdominal aortic aneurysms

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0202672 ◽  
Author(s):  
Eva L. Leemans ◽  
Tineke P. Willems ◽  
Cornelis H. Slump ◽  
Maarten J. van der Laan ◽  
Clark J. Zeebregts
Keyword(s):  
Risk Assessment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Rupture Risk ◽  
Abdominal Aortic ◽  
Additional Value

scholarly journals Turnover of fibrillar collagen in soft biological tissue with application to the expansion of abdominal aortic aneurysms

2012 ◽  
Vol 9 (77) ◽  
pp. 3366-3377 ◽  
Author(s):  
Giampaolo Martufi ◽  
T. Christian Gasser
Keyword(s):  
Stress Field ◽  
Vascular Tissue ◽  
High Stress ◽  
Vascular Wall ◽  
Aortic Aneurysms ◽  
Model Parameters ◽  
Fibrillar Collagen ◽  
Collagen Turnover ◽  
Abdominal Aortic ◽  
The Impact

A better understanding of the inherent properties of vascular tissue to adapt to its mechanical environment is crucial to improve the predictability of biomechanical simulations. Fibrillar collagen in the vascular wall plays a central role in tissue adaptation owing to its relatively short lifetime. Pathological alterations of collagen turnover may fail to result in homeostasis and could be responsible for abdominal aortic aneurysm (AAA) growth at later stages of the disease. For this reason our previously reported multiscale constitutive framework (Martufi, G. & Gasser, T. C. 2011 J. Biomech . 44 , 2544–2550 ( doi:10.1016/j.jbiomech.2011.07.015 )) has been enriched by a collagen turnover model. Specifically, the framework's collagen fibril level allowed a sound integration of vascular wall biology, and the impact of collagen turnover on the macroscopic properties of AAAs was studied. To this end, model parameters were taken from the literature and/or estimated from clinical follow-up data of AAAs (on average 50.7 mm-large). Likewise, the in vivo stretch of the AAA wall was set, such that 10 per cent of collagen fibres were engaged. Results showed that the stretch spectrum, at which collagen fibrils are deposed, is the most influential parameter, i.e. it determines whether the vascular geometry grows, shrinks or remains stable over time. Most importantly, collagen turnover also had a remarkable impact on the macroscopic stress field. It avoided high stress gradients across the vessel wall, thus predicted a physiologically reasonable stress field. Although the constitutive model could be successfully calibrated to match the growth of small AAAs, a rigorous validation against experimental data is crucial to further explore the model's descriptive and predictive capabilities.

scholarly journals Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index

2015 ◽  
Vol 12 (113) ◽  
pp. 20150852 ◽  
Author(s):  
Stanislav Polzer ◽  
T. Christian Gasser
Keyword(s):  
Risk Assessment ◽  
Wall Thickness ◽  
Risk Index ◽  
Wall Stress ◽  
Aortic Aneurysms ◽  
Rupture Risk ◽  
Discriminative Power ◽  
Wall Strength ◽  
Abdominal Aortic ◽  
Wide Range

A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured ( n = 7) and intact ( n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly ( p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach.

scholarly journals ADAMTS Proteins and Vascular Remodeling in Aortic Aneurysms

Biomolecules ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 12
Author(s):  
Zakaria Mougin ◽  
Julia Huguet Herrero ◽  
Catherine Boileau ◽  
Carine Le Goff
Keyword(s):  
Vascular Remodeling ◽  
Potential Role ◽  
Dynamic Structure ◽  
Vascular Wall ◽  
Aortic Aneurysms ◽  
Cellular Behavior ◽  
Thoracic Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Different Types

Extracellular matrix (ECM) in the vascular wall is a highly dynamic structure composed of a set of different molecules such as elastins, collagens, fibronectin (Fn), laminins, proteoglycans, and polysaccharides. ECM undergoes remodeling processes to regulate vascular smooth muscle and endothelial cells’ proliferation, differentiation, and adhesion. Abnormalities affecting the ECM can lead to alteration in cellular behavior and from this, this can conduce to the development of pathologies. Metalloproteases play a key role in maintaining the homeostasis of ECM by mediating the cleavage of different ECM components. There are different types of metalloproteases: matrix metalloproteinases (MMPs), disintegrin and metalloproteinases (ADAMs), and ADAMs with thrombospondin motifs (ADAMTSs). ADAMTSs have been found to participate in cardiovascular physiology and diseases and specifically in aortic aneurysms. This review aims to decipher the potential role of ADAMTS proteins in the physiopathologic development of Thoracic Aortic Aneurysms (TAA) and Abdominal Aortic Aneurysms (AAA). This review will focus on what is known on the ADAMTS family involved in human aneurysms from human tissues to mouse models. The recent findings on THSD4 (encoding ADAMTSL6) mutations in TAA give a new insight on the involvement of the ADAMTS family in TAA.

Gene Expression Profiling in Abdominal Aortic Aneurysms After Finite Element Rupture Risk Assessment

2017 ◽  
Vol 24 (6) ◽  
pp. 861-869 ◽  
Author(s):  
Philipp Erhart ◽  
Sandra Schiele ◽  
Philip Ginsbach ◽  
Caspar Grond-Ginsbach ◽  
Maani Hakimi ◽  
...  
Keyword(s):  
Gene Expression ◽  
Risk Assessment ◽  
Finite Element ◽  
Gene Expression Profiling ◽  
Expression Profiling ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Rupture Risk ◽  
Abdominal Aortic
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