It is generally acknowledged that rupture of an abdominal aortic aneurysm (AAA) occurs when the stress acting on the wall over the cardiac cycle exceeds the strength of the wall. Peak wall stress computations appear to give a more accurate rupture risk assessment than AAA diameter, which is currently used for a diagnose. Despite the numerous studies utilizing patient-specific wall stress modeling of AAAs, none investigated the effect of wall calcifications on wall stress. The objective of this study was to evaluate the influence of calcifications on patient-specific finite element stress computations. In addition, we assessed whether the effect of calcifications could be predicted directly from the CT-scans by relating the effect to the amount of calcification present in the AAA wall. For 6 AAAs, the location and extent of calcification was identified from CT-scans. A finite element model was created for each AAA and the areas of calcification were defined node-wise in the mesh of the model. Comparisons are made between maximum principal stress distributions, computed without calcifications and with calcifications with varying material properties. Peak stresses are determined from the stress results and related to a calcification index (CI), a quantification of the amount of calcification in the AAA wall. At calcification sites, local stresses increased, leading to a peak stress increase of 22% in the most severe case. Our results displayed a weak correlation between the CI and the increase in peak stress. Additionally, the results showed a marked influence of the calcification elastic modulus on computed stresses. Inclusion of calcifications in finite element analysis of AAAs resulted in a marked alteration of the stress distributions and should therefore be included in rupture risk assessment. The results also suggest that the location and shape of the calcified regions—not only the relative amount—are considerations that influence the effect on AAA wall stress. The dependency of the effect of the wall stress on the calcification elastic modulus points out the importance of determination of the material properties of calcified AAA wall.
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e-mail: vorpda@upmc.edu
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February 2007
Technical Papers
Effects of Wall Calcifications in Patient-Specific Wall Stress Analyses of Abdominal Aortic Aneurysms
Lambert Speelman,
Lambert Speelman
Departments of Biomedical Engineering and Medical Engineering,
Eindhoven University of Technology
, Eindhoven, The Netherlands
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Ajay Bohra,
Ajay Bohra
Departments of Surgery and Bioengineering, McGowan Institute for Regenerative Medicine,
University of Pittsburgh
, Pittsburgh, PA 15219
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E. Marielle H. Bosboom,
E. Marielle H. Bosboom
Department of General Surgery,
University Hospital Maastricht
, Maastricht, The Netherlands
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Geert Willem H. Schurink,
Geert Willem H. Schurink
Department of General Surgery,
University Hospital Maastricht
, Maastricht, The Netherlands
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Frans N. van de Vosse,
Frans N. van de Vosse
Departments of Biomedical Engineering and Medical Engineering,
Eindhoven University of Technology
, Eindhoven, The Netherlands
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Michel S. Makaroun,
Michel S. Makaroun
Department of Surgery, Division of Vascular Surgery,
University of Pittsburgh
, Pittsburgh, PA 15219
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David A. Vorp
David A. Vorp
Departments of Surgery and Bioengineering, McGowan Institute for Regenerative Medicine,
e-mail: vorpda@upmc.edu
University of Pittsburgh
, Pittsburgh, PA 15219
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Lambert Speelman
Departments of Biomedical Engineering and Medical Engineering,
Eindhoven University of Technology
, Eindhoven, The Netherlands
Ajay Bohra
Departments of Surgery and Bioengineering, McGowan Institute for Regenerative Medicine,
University of Pittsburgh
, Pittsburgh, PA 15219
E. Marielle H. Bosboom
Department of General Surgery,
University Hospital Maastricht
, Maastricht, The Netherlands
Geert Willem H. Schurink
Department of General Surgery,
University Hospital Maastricht
, Maastricht, The Netherlands
Frans N. van de Vosse
Departments of Biomedical Engineering and Medical Engineering,
Eindhoven University of Technology
, Eindhoven, The Netherlands
Michel S. Makaroun
Department of Surgery, Division of Vascular Surgery,
University of Pittsburgh
, Pittsburgh, PA 15219
David A. Vorp
Departments of Surgery and Bioengineering, McGowan Institute for Regenerative Medicine,
University of Pittsburgh
, Pittsburgh, PA 15219e-mail: vorpda@upmc.edu
J Biomech Eng. Feb 2007, 129(1): 105-109 (5 pages)
Published Online: July 27, 2006
Article history
Received:
January 23, 2006
Revised:
July 27, 2006
Citation
Speelman, L., Bohra, A., Bosboom, E. M. H., Schurink, G. W. H., van de Vosse, F. N., Makaroun, M. S., and Vorp, D. A. (July 27, 2006). "Effects of Wall Calcifications in Patient-Specific Wall Stress Analyses of Abdominal Aortic Aneurysms." ASME. J Biomech Eng. February 2007; 129(1): 105–109. https://doi.org/10.1115/1.2401189
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