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International Angiology 2011 October;30(5):462-6


language: English

Studying the expansion of small abdominal aortic aneurysms: is there a role for peak wall stress?

Georgakarakos E. 1, Ioannou C. V. 1, Papaharilaou Y. 2, Kostas T. 1, Kozyrakis G. V. 2, Katsamouris A. N. 1

1 Department of Vascular Surgery, University of Crete Medical School, Heraklion, Greece 2 Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Greece


AIM:The aim of this paper was to study the characteristics of three distending small abdominal aortic aneurysms (AAAs), with an increase in maximal diameter from 5 to 5.5 cm or above.
METHODS: Peak Wall Stress (PWS) in the presence and absence of intraluminal thrombus (ILT) was evaluated in 3 cases of small AAAs (5 cm), at initial presentation and after their expansion, at maximum diameters ≥5.5 cm using finite element analysis. Furthermore, AAA sac volume (Vsac), the percentage volume of ILT (ILT%) and the percentage change of Vsac (ΔV%) and ILT (ILT%) were estimated and the location of PWS was recorded.
RESULTS: Two AAA expanded from 5cm to 5.5 cm in a period of 6 months after initial presentation, with increase of sac volume by 20% and 30%, respectively. The third AAA expanded to a diameter of 6.5 cm after a follow-up period of 13 months, with a subsequent increase in sac volume of 78%. The expansion of AAA max diameter did not correlate with differences in peak wall stress (PWS) values at the initial presentation, ranging from 20.5 to 21.3 Nt/cm2.
CONCLUSION: PWS values cannot solely serve as a predictive tool for small AAA expansion. Small AAA expansion seem to be a multifactorial process, not solely described by PWS values but rather by a combination of mechanical, hemodynamic and biological factors.

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