Histologic, histochemical, and biomechanical properties of fragments isolated from the anterior wall of abdominal aortic aneurysms

Objective To analyze biomechanical, histologic, and histochemical properties of anterior fragments of abdominal aortic aneurysms (AAA) and to correlate them with the maximum transverse diameter (MTD) and symptoms associated to the aneurysms. Methods Fragments of the anterior aneurysm wall were obtai...

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Bibliographic Details
Published in:Journal of vascular surgery 2014-05, Vol.59 (5), p.1393-1401.e2
Main Authors: Tavares Monteiro, José Augusto, MD, PhD, da Silva, Erasmo Simão, PhD, Raghavan, Madhavan L., PhD, Puech-Leão, Pedro, PhD, de Lourdes Higuchi, Maria, PhD, Otoch, José Pinhata, PhD
Format: Article
Language:English
Subjects:
Aorta, Abdominal - chemistry
Aorta, Abdominal - pathology
Aorta, Abdominal - surgery
Aortic Aneurysm, Abdominal - complications
Aortic Aneurysm, Abdominal - metabolism
Aortic Aneurysm, Abdominal - pathology
Aortic Aneurysm, Abdominal - surgery
Aortic Rupture - etiology
Aortic Rupture - pathology
Biomechanical Phenomena
Brazil
Elastic Tissue - pathology
Elasticity
Female
Fibrillar Collagens - analysis
Humans
Inflammation - pathology
Male
Myocytes, Smooth Muscle - pathology
Prospective Studies
Risk Factors
Stress, Mechanical
Surgery
Tensile Strength
Vascular Stiffness
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Summary:Objective To analyze biomechanical, histologic, and histochemical properties of anterior fragments of abdominal aortic aneurysms (AAA) and to correlate them with the maximum transverse diameter (MTD) and symptoms associated to the aneurysms. Methods Fragments of the anterior aneurysm wall were obtained from 90 patients submitted to open repair of AAA of degenerative etiology from 2004 to 2009 in the Clinics Hospital of São Paulo University Medical School. Two specimens were produced from the fragments: one for histologic analysis for quantification of collagen fibers, elastic fibers, smooth muscle cells, and degree of inflammatory activity and the other for uniaxial tensile test to assess biomechanical failure properties of the material, such as strength, tension, and stress. Cases were classified according to symptoms and to the AAA MTD. Results Fragments from AAA with MTD < 5.5 cm showed higher values for biomechanical failure properties than those of AAA with MTD < 5.5 cm (strength, 5.32 ± 2.07 × 4.1 ± 2.41 N; tension, 13.83 ± 5.58 × 10.82 ± 6.48 N/cm; stress, 103.02 × 77.03 N/cm2 ; P  < .05). No differences were observed between the groups in relation to failure strain (0.41 ± 0.12 × 0.37 ± 0.14; P  = .260) and thickness of the fragments (1.58 ± 0.41 × 1.53 ± 0.42 mm; P  = .662). The average values of fiber compositions of all the fragments were as follows: collagen fibers, 44.34 ± 0.48% and 61.85 ± 10.14% (Masson trichrome staining and Picrosirius red staining, respectively); smooth muscle cells, 3.46 ± 2.23% (immunohistochemistry/alpha-actin); and elastic fibers, less than 1% (traces) (Verhoeff-van Gieson staining). No differences in fiber percentages (collagen, elastic, and smooth muscle) were observed in fragments from AAA with MTD
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2013.04.064