Annals of vascular surgery · 2026
Hemodynamic Differences Associated with Extreme Versus Minimal Proximal Neck Angulation in Ruptured Infrarenal Abdominal Aortic Aneurysms: A Patient-Specific Computational Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Li Ruchen, Song Qingpeng, Wang Xiaohan, Wang Jiacheng, Wu Xuejun
Аннотация
BACKGROUND: Maximum aneurysm diameter remains the principal criterion for abdominal aortic aneurysm (AAA) risk assessment, but additional morphologic and biomechanical factors may help explain the heterogeneity of rupture-related vulnerability. This exploratory study aimed to characterize hemodynamic differences associated with extreme versus minimal proximal neck angulation in ruptured infrarenal AAAs.
METHODS: Preoperative computed tomography angiography datasets from six patients with ruptured infrarenal AAAs were retrospectively analyzed. Cases were categorized into an extreme angulation group (70° < β < 90°, n = 3) and a minimal angulation group (β < 5°, n = 3). Patient-specific computational fluid dynamics models were reconstructed to compare intrasac flow pattern, wall pressure distribution, and wall shear stress (WSS).
RESULTS: Compared with minimal angulation, extreme proximal neck angulation was associated with more disturbed intrasac flow, greater flow acceleration at the neck-sac junction, and more heterogeneous wall pressure and WSS distributions. Minimally angulated aneurysms showed relatively laminar flow, whereas severely angulated aneurysms demonstrated more prominent recirculation and flow disorder. Regions of abnormal hemodynamic behavior showed qualitative spatial concordance with clinically identified rupture sites.
CONCLUSION: In this small exploratory series of ruptured infrarenal AAAs, extreme proximal neck angulation was associated with a more adverse intrasac hemodynamic environment than minimal angulation. These findings are descriptive and hypothesis-generating, do not establish reproducible hemodynamic patterns or rupture risk prediction, and require validation in larger, preferably multicenter, comparative studies including both ruptured and intact AAAs.
METHODS: Preoperative computed tomography angiography datasets from six patients with ruptured infrarenal AAAs were retrospectively analyzed. Cases were categorized into an extreme angulation group (70° < β < 90°, n = 3) and a minimal angulation group (β < 5°, n = 3). Patient-specific computational fluid dynamics models were reconstructed to compare intrasac flow pattern, wall pressure distribution, and wall shear stress (WSS).
RESULTS: Compared with minimal angulation, extreme proximal neck angulation was associated with more disturbed intrasac flow, greater flow acceleration at the neck-sac junction, and more heterogeneous wall pressure and WSS distributions. Minimally angulated aneurysms showed relatively laminar flow, whereas severely angulated aneurysms demonstrated more prominent recirculation and flow disorder. Regions of abnormal hemodynamic behavior showed qualitative spatial concordance with clinically identified rupture sites.
CONCLUSION: In this small exploratory series of ruptured infrarenal AAAs, extreme proximal neck angulation was associated with a more adverse intrasac hemodynamic environment than minimal angulation. These findings are descriptive and hypothesis-generating, do not establish reproducible hemodynamic patterns or rupture risk prediction, and require validation in larger, preferably multicenter, comparative studies including both ruptured and intact AAAs.