Publication detail

The impact of Intra-luminal Thrombus failure on the mechanical stress in the wall of Abdominal Aortic Aneurysms

POLZER, S. BURŠA, J. SWEDENBORG, J. GASSER, T.

Original Title

The impact of Intra-luminal Thrombus failure on the mechanical stress in the wall of Abdominal Aortic Aneurysms

English Title

The impact of Intra-luminal Thrombus failure on the mechanical stress in the wall of Abdominal Aortic Aneurysms

Type

journal article - other

Language

en

Original Abstract

The role of the Intra-luminal Thrombus (ILT) in Abdominal Aortic Aneurysm (AAA) rupture is controversial and it is still not clear if an ILT increases or decreases AAA rupture risk. Specifically, signs of bleeding in the ILT are thought to increase AAA rupture risk. In order to further investigate this hypothesis, intact AAAs (n=4) with clear signs of ILT rupture in Computer Tomography Angiography (CT-A) images were investigated. To this end two cases were investigated: an ILT failure extracted directly from the CT-A data and a hypothetical ILT fissure connecting the lumen with the underlying aneurysm wall. Wall stress distributions were predicted based on the detailed Finite Element (FE) models. The study showed that the ILT rupture, as extracted from the CT-A data, can increase the mechanical stress in the underlying wall by up to 30%. The largest impact on the wall stress was observed if the ILT failure reaches the aneurysm wall or if it involves large parts of the ILT. In contrast, a concentric failure in the medial ILT not reaching the wall has almost no impact on the wall stress distribution. Finally, the insertion of the hypothetical crack in the ILT can even double the stress of the underlying wall. In conclusion, the ILT failure redistributes the wall stress and, if it reaches the wall or involves large parts of the ILT, it can potentially trigger the AAA rupture.

English abstract

The role of the Intra-luminal Thrombus (ILT) in Abdominal Aortic Aneurysm (AAA) rupture is controversial and it is still not clear if an ILT increases or decreases AAA rupture risk. Specifically, signs of bleeding in the ILT are thought to increase AAA rupture risk. In order to further investigate this hypothesis, intact AAAs (n=4) with clear signs of ILT rupture in Computer Tomography Angiography (CT-A) images were investigated. To this end two cases were investigated: an ILT failure extracted directly from the CT-A data and a hypothetical ILT fissure connecting the lumen with the underlying aneurysm wall. Wall stress distributions were predicted based on the detailed Finite Element (FE) models. The study showed that the ILT rupture, as extracted from the CT-A data, can increase the mechanical stress in the underlying wall by up to 30%. The largest impact on the wall stress was observed if the ILT failure reaches the aneurysm wall or if it involves large parts of the ILT. In contrast, a concentric failure in the medial ILT not reaching the wall has almost no impact on the wall stress distribution. Finally, the insertion of the hypothetical crack in the ILT can even double the stress of the underlying wall. In conclusion, the ILT failure redistributes the wall stress and, if it reaches the wall or involves large parts of the ILT, it can potentially trigger the AAA rupture.

Keywords

Intra-luminal Thrombus, failure risk, finite element analysis, Abdominal Aortic Aneurysms

RIV year

2011

Released

18.02.2011

Publisher

Elsevier

Pages from

467

Pages to

473

Pages count

7

Documents

BibTex


@article{BUT72588,
  author="Stanislav {Polzer} and Thomas Christian {Gasser} and Jesper {Swedenborg} and Jiří {Burša}",
  title="The impact of Intra-luminal Thrombus failure on the mechanical stress in the wall of Abdominal Aortic Aneurysms",
  annote="The role of the Intra-luminal Thrombus (ILT) in Abdominal Aortic Aneurysm (AAA) rupture is controversial and it is still not clear if an ILT increases or decreases AAA rupture risk. Specifically, signs of bleeding in the ILT are thought to increase AAA rupture risk. In order to further investigate this hypothesis, intact AAAs (n=4) with clear signs of ILT rupture in Computer Tomography Angiography (CT-A) images were investigated. To this end two cases were investigated: an ILT failure extracted directly from the CT-A data and a hypothetical ILT fissure connecting the lumen with the underlying aneurysm wall. Wall stress distributions were predicted based on the detailed Finite Element (FE) models. The study showed that the ILT rupture, as extracted from the CT-A data, can increase the mechanical stress in the underlying wall by up to 30%.  The largest impact on the wall stress was observed if the ILT failure reaches the aneurysm wall or if it involves large parts of the ILT. In contrast, a concentric failure in the medial ILT not reaching the wall has almost no impact on the wall stress distribution. Finally, the insertion of the hypothetical crack in the ILT can even double the stress of the underlying wall. In conclusion, the ILT failure redistributes the wall stress and, if it reaches the wall or involves large parts of the ILT, it can potentially trigger the AAA rupture.",
  address="Elsevier",
  chapter="72588",
  institution="Elsevier",
  journal="EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY",
  number="4",
  volume="41",
  year="2011",
  month="february",
  pages="467--473",
  publisher="Elsevier",
  type="journal article - other"
}