Biological, Geometric and Biomechanical Factors Influencing Abdominal Aortic Aneurysm Rupture Risk: A Comprehensive Review
Samarth S. Raut, Santanu Chandra, Judy Shum, Christopher B. Washington, Satish C. Muluk, Ender A. Finol and Jose F. Rodriguez
Affiliation: Department of Mechanical Engineering, University of Zaragoza Edf, Betancourt S/N, Maria de Luna, Zaragoza 50018, Zaragoza, Spain.
The current clinical management of abdominal aortic aneurysm (AAA) disease is based to a great extent on
measuring the aneurysm maximum diameter to decide when timely intervention is required. Decades of clinical evidence
show that aneurysm diameter is positively associated with the probability of rupture, but that other parameters may also
play a role in causing or predisposing the AAA to rupture. Biological factors associated with smooth muscle apoptosis are
implicated in AAA expansion while geometric and biomechanical factors identified by means of computational modeling
techniques have been positively correlated with rupture risk with a higher accuracy and sensitivity than maximum
diameter alone. The objective of this review is to examine the factors found to influence AAA disease progression,
clinical management and rupture, as well as a patent review that highlights developments in this arena in the past few
Keywords: Abdominal aortic aneurysm, biological factor of AAA growth, biomechanical factors of AAA rupture, geometric
factors of AAA rupture risk, intraluminal thrombus (ILT), tissue inhibitors of metalloproteinases (TIMP), wall stress.
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