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    Intrasac Pressure Changes and Vascular Remodeling After Endovascular Repair of Abdominal Aortic Aneurysms: Review and Biomechanical Model Simulation

    Source: Journal of Biomechanical Engineering:;2011:;volume( 133 ):;issue: 001::page 11011
    Author:
    S. T. Kwon
    ,
    J. E. Rectenwald
    ,
    S. Baek
    DOI: 10.1115/1.4003134
    Publisher: The American Society of Mechanical Engineers (ASME)
    Abstract: In this paper, we review existing clinical research data on post-endovascular repair (EVAR) intrasac pressure and relation with abdominal aortic aneurysm (AAA) size changes. Based on the review, we hypothesize that intrasac pressure has a significant impact on post-EVAR AAA size changes, and post-EVAR remodeling depends also on how the pressure has changed over a period of time. The previously developed model of an AAA based on a constrained mixture approach is extended to include vascular adaptation after EVAR using an idealized geometry. Computational simulation shows that the same mechanism of collagen stress-mediated remodeling in AAA expansion induces the aneurysm wall to shrink in a reduced sac-pressure after post-EVAR. Computational simulation suggests that the intrasac pressure of 60 mm Hg is a critical value. At this value, the AAA remains stable, while values above cause the AAA to expand and values below cause the AAA to shrink. There are, however, variations between individuals due to different cellular sensitivities in stress-mediated adaptation. Computer simulation also indicates that an initial decrease in intrasac pressure helps the AAA shrink even if the pressure increases after some time. The presented study suggests that biomechanics has a major effect on initial adaptation after EVAR and also illustrates the utility of a computational model of vascular growth and remodeling in predicting diameter changes during the progression and after the treatment of AAAs.
    keyword(s): Pressure , Aneurysms , Simulation , Maintenance AND Biomechanics ,
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      Intrasac Pressure Changes and Vascular Remodeling After Endovascular Repair of Abdominal Aortic Aneurysms: Review and Biomechanical Model Simulation

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    http://yetl.yabesh.ir/yetl1/handle/yetl/145507
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    contributor authorS. T. Kwon
    contributor authorJ. E. Rectenwald
    contributor authorS. Baek
    date accessioned2017-05-09T00:42:38Z
    date available2017-05-09T00:42:38Z
    date copyrightJanuary, 2011
    date issued2011
    identifier issn0148-0731
    identifier otherJBENDY-27188#011011_1.pdf
    identifier urihttp://yetl.yabesh.ir/yetl/handle/yetl/145507
    description abstractIn this paper, we review existing clinical research data on post-endovascular repair (EVAR) intrasac pressure and relation with abdominal aortic aneurysm (AAA) size changes. Based on the review, we hypothesize that intrasac pressure has a significant impact on post-EVAR AAA size changes, and post-EVAR remodeling depends also on how the pressure has changed over a period of time. The previously developed model of an AAA based on a constrained mixture approach is extended to include vascular adaptation after EVAR using an idealized geometry. Computational simulation shows that the same mechanism of collagen stress-mediated remodeling in AAA expansion induces the aneurysm wall to shrink in a reduced sac-pressure after post-EVAR. Computational simulation suggests that the intrasac pressure of 60 mm Hg is a critical value. At this value, the AAA remains stable, while values above cause the AAA to expand and values below cause the AAA to shrink. There are, however, variations between individuals due to different cellular sensitivities in stress-mediated adaptation. Computer simulation also indicates that an initial decrease in intrasac pressure helps the AAA shrink even if the pressure increases after some time. The presented study suggests that biomechanics has a major effect on initial adaptation after EVAR and also illustrates the utility of a computational model of vascular growth and remodeling in predicting diameter changes during the progression and after the treatment of AAAs.
    publisherThe American Society of Mechanical Engineers (ASME)
    titleIntrasac Pressure Changes and Vascular Remodeling After Endovascular Repair of Abdominal Aortic Aneurysms: Review and Biomechanical Model Simulation
    typeJournal Paper
    journal volume133
    journal issue1
    journal titleJournal of Biomechanical Engineering
    identifier doi10.1115/1.4003134
    journal fristpage11011
    identifier eissn1528-8951
    keywordsPressure
    keywordsAneurysms
    keywordsSimulation
    keywordsMaintenance AND Biomechanics
    treeJournal of Biomechanical Engineering:;2011:;volume( 133 ):;issue: 001
    contenttypeFulltext
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