Increased Anterior Abdominal Aortic Wall Motion: Possible Role in Aneurysm Pathogenesis and Design of Endovascular Devices

2007 ◽  
Vol 14 (4) ◽  
pp. 574-584 ◽  
Author(s):  
Craig J. Goergen ◽  
Bonnie L. Johnson ◽  
Joan M. Greve ◽  
Charles A. Taylor ◽  
Christopher K. Zarins
Keyword(s):  
Body Mass ◽  
Wall Motion ◽  
Aortic Wall ◽  
Cyclic Strain ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Dynamic Strain ◽  
Wall Displacement ◽  
Abdominal Aortic ◽  
Endovascular Devices

Purpose: To determine whether variations in aortic wall motion exist in mammalian species other than humans and to consider the potential implications of such variations. Methods: M-mode ultrasound was used to measure abdominal aortic wall motion in 4 animal species [mice (n=10), rats (n=8), rabbits (n=7), and pigs (n=5)], and humans (n=6). Anterior wall displacement, posterior wall displacement, and diastolic diameter were measured. The ratio of displacement to diameter and cyclic strain were calculated. Results: Body mass varied from 24.1±2.4 g (mouse) to 61.8±13.4 kg (human); aortic diameter varied from 0.53±0.07 mm (mouse) to 1.2±1 mm (human). Anterior wall displacement was 2.5 to 4.0 times greater than posterior among the species studied. The ratios of wall displacement to diastolic diameter were similar for the anterior (range 9.40%–11.80%) and posterior (range 2.49%–3.91%) walls among species. The ratio of anterior to posterior displacement (range 2.47–4.03) and aortic wall circumferential cyclic strain (range 12.1%–15.7%) were also similar. An allometric scaling exponent was experimentally derived relating anterior wall (0.377±0.032, R2=0.94) and posterior wall (0.378±0.037, R2=0.93) displacement to body mass. Conclusion: Abdominal aortic wall dynamics are similar in animals and humans regardless of aortic size, with more anterior than posterior wall motion. Wall displacement increases linearly with diameter, but allometrically with body mass. These data suggest increased dynamic strain of the anterior wall. Increased strain, corresponding to increased elastin fatigue, may help explain why human abdominal aortic aneurysms initially develop anteriorly. Aortic wall motion should be considered when developing endovascular devices, since asymmetric motion may affect device migration, fixation, and sealing.

Increased Anterior Abdominal Aortic Wall Motion: Possible Role in Aneurysm Pathogenesis and Design of Endovascular Devices

2007 ◽  
Vol 14 (4) ◽  
pp. 574-584 ◽  
Author(s):  
Craig J. Goergen ◽  
Bonnie L. Johnson ◽  
Joan M. Greve ◽  
Charles A. Taylor ◽  
Christopher K. Zarins
Keyword(s):  
Wall Motion ◽  
Aortic Wall ◽  
Abdominal Aortic ◽  
Endovascular Devices

scholarly journals Echocardiographic Evaluation of the Thoracic Aorta: Tips and Pitfalls

Aorta ◽  
2021 ◽  
Vol 09 (01) ◽  
pp. 001-008
Author(s):  
Krishna Upadhyaya ◽  
Ifeoma Ugonabo ◽  
Keyuree Satam ◽  
Sarah C. Hull
Keyword(s):  
Aortic Dissection ◽  
Aortic Wall ◽  
Ultrasound Image ◽  
Leading Edge ◽  
Posterior Wall ◽  
Blind Spot ◽  
Anterior Wall ◽  
Ascending Aorta ◽  
Color Flow ◽  
Leading Edges

AbstractBy convention, the ascending aorta is measured by echo from leading edge to leading edge. “Leading edge” connotes the edge of the aortic wall that is closest to the probe (at the top of the inverted “V” of the ultrasound image). By transthoracic echo (TTE), the leading edges are the outer anterior wall and inner posterior wall. By transesophageal echo (TEE), the leading edges are the outer posterior wall and inner anterior wall. Aortic measurements should be taken (by convention) in diastole (when the aorta is moving least). Simple TTE is 70 to 85% sensitive in diagnosing ascending aortic dissection. TEE sensitivity approaches 100%, though the tracheal carina imposes a blind spot on TEE, impeding visualization of distal ascending aorta and proximal aortic arch. While computed tomography angiography may be superior for defining full anatomic extent of aortic dissection, echocardiography is superior in assessing functional consequences such as mechanism and severity of aortic regurgitation, evidence of myocardial ischemia when complicated by coronary dissection, or evidence of tamponade physiology when pericardial effusion is present. Reverberation artifact can mimic a dissection flap. A true flap moves independently of the outer aortic wall which can be confirmed by M-mode. Color flow respects a true flap but does not respect a reverberation artifact. Assessment for bicuspid aortic valve (BAV) morphology should be done in systole, not diastole. In diastole, when the valve is closed, the raphé can make a bicuspid valve appear trileaflet. Doming in the parasternal long axis (PLAX) view and an eccentric closure line on PLAX M-mode should also raise suspicion for BAV.

Measurement of the Local Strain of the Porcine Thoracic Aorta During the Inflation Test

2010 ◽  
Author(s):  
Jungsil Kim ◽  
Seungik Baek
Keyword(s):  
Aortic Wall ◽  
Circulatory System ◽  
Cylindrical Tube ◽  
Local Strain ◽  
Posterior Wall ◽  
In Vivo Studies ◽  
Wall Displacement ◽  
Nonuniform Deformation ◽  
Circulatory System Diseases

The aorta is the main artery and plays an important role in the blood circulatory system. Diseases of the aorta such as aortic aneurysm and aortic dissection have high mortality rates, hence the study of the mechanical properties of the aorta has been an active research area. In many previous studies, the aorta has been considered as a straight cylindrical tube undergoing uniform circumferential deformation and therefore uniform strain/stress distribution in the circumferential direction. However, recent biomedical imaging studies show that the aorta has circumferentially nonuniform deformation during the cardiac cycle [1] and the aortic wall distends asymmetrically [2]. Furthermore, it has been shown that the anterior wall displacement is larger than the posterior wall displacement [3]. These in vivo studies have raised yet another question as to whether nonuniform deformation is due to the inhomogeneous properties of the aortic wall or due to surrounding tissues.

Abdominal aortic wall motion of healthy and hypertensive subjects: Evaluation of tissue Doppler velocity imaging

2008 ◽  
Vol 36 (4) ◽  
pp. 218-225 ◽  
Author(s):  
Ying Huang ◽  
Bing Hu ◽  
Pin-Tong Huang ◽  
Hai-Yan Sun ◽  
Jia-An Zhu
Keyword(s):  
Wall Motion ◽  
Aortic Wall ◽  
Tissue Doppler ◽  
Doppler Velocity ◽  
Velocity Imaging ◽  
Abdominal Aortic

Abstract 105: Association of Viscoelastic Material Properties and Extracellular Matrix Remodeling in Human Abdominal Aortic Aneurysmal Tissue

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Doran S Mix ◽  
Sandra A Toth ◽  
Ibrahima Bah ◽  
Michael C Stoner ◽  
Bruce I Goldman ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Western Blot ◽  
Viscoelastic Material ◽  
Material Properties ◽  
Aortic Wall ◽  
Cyclic Strain ◽  
Wall Stress ◽  
Aortic Tissue ◽  
Matrix Remodeling ◽  
Abdominal Aortic

Objectives: Predicting rupture of abdominal aortic aneurysm (AAA) requires knowledge of both the rate of extracellular matrix (ECM) degradation and the pulsatile stress on the aortic tissue. The activity of matrix metallopeptidase 9 (MMP9) and its inhibitor, TIMP1, are associated with alterations in aortic ECM but it is unknown if these changes effect the dynamic viscoelastic properties. We hypothesize that increased levels of MMP9 within AAA tissue will be associated with a greater dynamic modulus (E*), as a surrogate of increased aortic wall stress. Methods: Human aneurysmal aortic tissue was obtained at the time of open AAA repair (n=11) and age-matched non-aneurysmal cadavers (n=10). Uniaxial viscoelastic material properties were measured in the circumferential orientation under physiologic preload (110 mmHg) and cyclic strain (± 5%@1Hz). Quantitative histologic and immunohistochemistry were preformed using Fiji imaging software. Aortic MMP9 and TIMP1 content and activity were quantified using western blot and zymography. Results: E* was greater (1862±464 vs 1362±405 kPa, p=0.02) in the AAA tissue as compared to non-aneurysmal tissue. AAA tissue contained less elastin (6.7±6.7 vs 23.4±8.7%, p=0.01) and a greater collagen/elastin ratio (19.9±20.6 vs 2.3±2.5%, p=0.05). Immunohistochemistry revealed 200% greater MMP9 content in the AAA tissue (Figure A & B, 0.61 vs 0.03%, p=0.03). Increased MMP9 content was confirmed using a western blot (0.43 vs 0.06 AU, p<0.01). No difference in relative MMP9 activity (4307 vs 2324 AU, p=0.25) or level of TIMP1 (0.03 vs 0.02, p=0.6) were observed. There was a positive linear correlation (Figure C, r 2 =0.47) between E* and MMP9 as determined by quantitative immunohistochemistry. Conclusions: Our data suggests a positive relationship between E* and MMP9 content. Increased tissue stiffness may trigger MMP9 production resulting in a positive-feedback loop, progressively increasing aortic wall stress and rupture risk.

Anterior Mediastinal Paraganglioma Mimicking Thymoma

2012 ◽  
Vol 15 (3) ◽  
pp. 170
Author(s):  
Hee Moon Lee ◽  
Dong Seop Jeong ◽  
Pyo Won Park ◽  
Wook Sung Kim ◽  
Kiick Sung ◽  
...  
Keyword(s):  
Mediastinal Mass ◽  
Aortic Wall ◽  
Anterior Wall ◽  
Ascending Aorta ◽  
Anterior Mediastinal Mass ◽  
Arterial Reconstruction ◽  
Ct Evaluation ◽  
One Year ◽  
Mediastinal Paraganglioma

A 54-year-old man was referred to our institution with hemoptysis and hoarseness of 1 year's duration. A computed tomography (CT) scan showed an anterior mediastinal mass (2.5 cm x 1.0 cm), which was diagnosed as thymoma. The tumor was resected under a sternotomy. The tumor had invaded the anterior wall of the ascending aorta. With the patient under cardiopulmonary bypass, the aortic wall invaded by the mass was resected, and arterial reconstruction was performed with patch material. The tumor was revealed to be a tumor of neuronal origin. The patient's postoperative course was uneventful. The patient was discharged on postoperative day 9. One year after the operation, a follow-up chest CT evaluation showed no specific complications or recurrence.

scholarly journals Initial Clinical Experience With a New Conformable Abdominal Aortic Endograft: Aortic Neck Coverage and Curvature Analysis in Challenging Aortic Necks

2021 ◽  
pp. 152660282199672
Author(s):  
Alice Finotello ◽  
Richte Schuurmann ◽  
Sara Di Gregorio ◽  
Gian Antonio Boschetti ◽  
Nabil Chakfé ◽  
...  
Keyword(s):  
Aortic Wall ◽  
Surface Coverage ◽  
Infrarenal Aorta ◽  
Technical Success ◽  
Curvature Analysis ◽  
Average Curvature ◽  
Aortic Neck ◽  
Abdominal Aortic ◽  
Shortest Distance ◽  
New Generation

Objectives: Aim of this work was to investigate precision of deployment and conformability of a new generation GORE EXCLUDER Conformable Endoprosthesis with active control system (CEXC Device, W.L. Gore and Associates, Flagstaff, AZ, USA) by analyzing aortic neck coverage and curvature. Methods: All consecutive elective patients affected by abdominal aortic aneurysm or aortoiliac aneurysm treated at our institution between November 2018 and June 2019 with the new CEXC Device were enrolled. Validated software was adopted to determine the available apposition surface area into the aortic neck, apposition of the endograft to the aortic wall, shortest apposition length (SAL), shortest distance between the endograft fabric and the lowest renal arteries (SFD) and between the endograft fabric and the contralateral renal artery (CFD). Pointwise centerline curvature was also computed. Results: Twelve patients (10 men, median age 78 years (71.75, 81.0)) with available pre- and postoperative computed tomography angiography (CTA) were included. Technical success was obtained in all the cases. Preoperative median length of the proximal aortic neck was 16.1 mm (10.7, 21.7) and suprarenal (α) and infrarenal (β) neck angulation were, respectively, 28.9° (15.7°, 47.5°) and 75.0° (66.9°, 81.4°). Postoperative median apposition surface coverage was 79% (69.25%, 90.75%) of the available apposition surface. SFD and CFD were 1.5 mm (0.75, 5.25) and 7 mm (4.5, 21.5), respectively. Average curvature over the infrarenal aorta decreased from 25 m−1 (21.75, 29.0) to 22.5 m−1 (18.75, 24.5) postoperatively (p=0.02). Maximum curvature did not decrease significantly from 64.5 m−1 (54.25, 92.0) to 62 m−1 (41.75, 71.5) (p=0.1). Conclusions: Our early experience showed that deployment of the CEXC Device is safe and effective for patients with challenging proximal aortic necks. Absence of significant changes between pre- and postoperative proximal aortic neck angulations and curvature confirms the high conformability of this endograft.

scholarly journals ASSOCIATION OF ABDOMINAL AORTIC WALL INFLAMMATION, HEPATIC FLUORODEOXYGLUCOSE UPTAKE AND VISCERAL ADIPOSE TISSUE BIOLOGICAL ACTIVITY IN PATIENTS WITH DYSLIPIDEMIAS

2017 ◽  
Vol 69 (11) ◽  
pp. 1436
Author(s):  
Koutagiar Peter Iosif ◽  
Konstantinos Toutouzas ◽  
Georgios Benetos ◽  
Nikoletta Piannou ◽  
Alexios Antonopoulos ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Biological Activity ◽  
Visceral Adipose Tissue ◽  
Aortic Wall ◽  
Abdominal Aortic ◽  
Visceral Adipose

A Novel Noninvasive Technique for Pulse-Wave Imaging and Characterization of Clinically-Significant Vascular Mechanical Properties In Vivo

2007 ◽  
Vol 29 (3) ◽  
pp. 137-154 ◽  
Author(s):  
Kana Fujikura ◽  
Jianwen Luo ◽  
Viktor Gamarnik ◽  
Mathieu Pernot ◽  
Royd Fukumoto ◽  
...  
Keyword(s):  
Aortic Wall ◽  
Pulse Wave ◽  
Distal Region ◽  
Noninvasive Technique ◽  
Abdominal Aortic ◽  
Wave Imaging ◽  
Risk Patients ◽  
Noninvasive Mapping ◽  
Clinically Significant

The pulse-wave velocity (PWV) has been used as an indicator of vascular stiffness, which can be an early predictor of cardiovascular mortality. A noninvasive, easily applicable method for detecting the regional pulse wave (PW) may contribute as a future modality for risk assessment. The purpose of this study was to demonstrate the feasibility and reproducibility of PW imaging (PWI) during propagation along the abdominal aortic wall by acquiring electrocardiography-gated (ECG-gated) radiofrequency (rf) signals noninvasively. An abdominal aortic aneurysm (AAA) was induced using a CaCl2 model in order to investigate the utility of this novel method for detecting disease. The abdominal aortas of twelve normal and five CaCl2, mice were scanned at 30 MHz and electrocardiography (ECG) was acquired simultaneously. The radial wall velocities were mapped with 8000 frames/s. Propagation of the PW was demonstrated in a color-coded ciné-loop format in all cases. In the normal mice, the wave propagated in linear fashion from a proximal to a distal region. However, in CaCl2 mice, multiple waves were initiated from several regions (i.e., most likely initiated from various calcified regions within the aortic wall). The regional PWV in normal aortas was 2.70 ± 0.54 m/s ( r2 = 0.85 ± 0.06, n = 12), which was in agreement with previous reports using conventional techniques. Although there was no statistical difference in the regional PWV between the normal and CaCl2-treated aortas (2.95 ± 0.90 m/s ( r2 = 0.51 ± 0.22, n = 5)), the correlation coefficient was found to be significantly lower in the CaCl2-treated aortas ( p<0.01). This state-of-the-art technique allows noninvasive mapping of vascular disease in vivo. In future clinical applications, it may contribute to the detection of early stages of cardiovascular disease, which may decrease mortality among high-risk patients.

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