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Biomechanical Characterization of Ascending Aortic Aneurysms

机译：升主动脉瘤的生物力学表征

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Ascending thoracic aortic aneurysms (ATAAs) are a silent disease, ultimately leading to dissection or rupture of the arterial wall. There is a growing consensus that diameter information is insufficient to assess rupture risk, whereas wall stress and strength provide a more reliable estimate. The latter parameters cannot be measured directly and must be inferred through biomechanical assessment, requiring a thorough knowledge of the mechanical behaviour of the tissue. However, for healthy and aneurysmal ascending aortic tissues, this knowledge remains scarce. This study provides the geometrical and mechanical properties of the ATAA of six patients with unprecedented detail. Prior to their ATAA repair, pressure and diameter were acquired non-invasively, from which the distensibility coefficient, pressure-strain modulus and wall stress were calculated. Uniaxial tensile tests on the resected tissue yielded ultimate stress and stretch values. Parameters for the Holzapfel-Gasser-Ogden material model were estimated based on the pre-operative pressure-diameter data and the post-operative stress-stretch curves from planar biaxial tensile tests. Our results confirmed that mechanical or geometrical information alone cannot provide sufficient rupture risk estimation. The ratio of physiological to ultimate wall stress seems a more promising parameter. However, wall stress estimation suffers from uncertainties in wall thickness measurement, for which our results show large variability, between patients but also between measurement methods. Our results also show a large strength variability, a value which cannot be measured non-invasively. Future work should therefore be directed towards improved accuracy of wall thickness estimation, but also towards the large-scale collection of ATAA wall strength data.
机译：升主动脉瘤 （ATAA） 是一种无声的疾病，最终导致动脉壁夹层或破裂。越来越多的共识认为，直径信息不足以评估破裂风险，而壁应力和强度提供了更可靠的估计。后一个参数不能直接测量，必须通过生物力学评估来推断，需要对组织的机械行为有透彻的了解。然而，对于健康和动脉瘤性升主动脉组织，这方面的知识仍然很少。这项研究以前所未有的细节提供了六名患者 ATAA 的几何和机械特性。在ATAA修复之前，以非侵入性方式获取压力和直径，从中计算膨胀系数、压力-应变模量和壁应力。对切除的组织进行单轴拉伸试验，得出极限应力和拉伸值。Holzapfel-Gasser-Ogden材料模型的参数基于术前压力-直径数据和平面双轴拉伸试验的术后应力-拉伸曲线进行估计。我们的研究结果证实，仅靠机械或几何信息无法提供足够的破裂风险估计。生理应力与极限壁应力的比值似乎是一个更有希望的参数。然而，壁应力估计在壁厚测量中存在不确定性，我们的结果显示，患者之间以及测量方法之间存在很大差异。我们的结果还显示出很大的强度变异性，该值无法非侵入性地测量。因此，未来的工作应着眼于提高壁厚估算的准确性，同时也应着眼于大规模收集ATAA壁厚数据。

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