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Molecular, Cellular, and Tissue Engineering of the Vascular System pp 157–179Cite as

Abdominal Aortic Aneurysm Pathomechanics: Current Understanding and Future Directions

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Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1097))

Abstract

Abdominal aortic aneurysms (AAAs) are permanent, local expansions of the abdominal segment of the aorta that can potentially be fatal if progressing to rupture. AAAs are rarely found in patients under age 60, but are more common in older age groups, occurring in 2–3% of the whole population. Their rupture produces up to 14,000 deaths annually in the United States alone. Because aneurysmal rupture is a mechanical phenomenon, in recent years there has been a major effort among researchers to investigate the biologic and mechanical processes surrounding AAA progression and rupture. In addition to the basic science importance of understanding AAA pathophysiology, much of this research has been directed toward the development of accurate clinical criteria for assessing the risk of rupture on a patient-by-patient basis. This review first summarizes degenerative changes of the aorta wall associated with AAA pathogenesis. Current understanding of hemodynamics, transport, and wall mechanics in AAAs is then described, and open questions in aneurysm research are discussed along with potential directions in which further understanding could lead to improved clinical evaluation and management decision processes.

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Acknowledgments

The authors thank Dr. Gerhard Holzapfel for the use of images 2b and 2d, Mr. Sudharsan Madhavan for the assistance with the preparation of Fig. 3, and Mr. Erik Edgar for the assistance with the preparation of Figs. 4 and 5. This work was supported by National Science Foundation [grant numbers CMMI-1031366, CMMI-1352955].

Declaration of Conflicting Interests The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Mechanical Engineering, Tufts University, Medford, MA, USA

    Erica M. C. Kemmerling

  2. Department of Surgery, Tufts Medical Center, Boston, MA, USA

    Robert A. Peattie

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Correspondence to Robert A. Peattie .

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  1. Department of Biomedical Engineering, The City College of the City University of New York, New York, NY, USA

    Bingmei M. Fu

  2. Department of Mechanical Engineering, Michigan State University, East Lansing, MI, USA

    Neil T. Wright

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Kemmerling, E.M.C., Peattie, R.A. (2018). Abdominal Aortic Aneurysm Pathomechanics: Current Understanding and Future Directions. In: Fu, B., Wright, N. (eds) Molecular, Cellular, and Tissue Engineering of the Vascular System. Advances in Experimental Medicine and Biology, vol 1097. Springer, Cham. https://doi.org/10.1007/978-3-319-96445-4_8

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