Biological, Geometric and Biomechanical Factors Influencing Abdominal Aortic Aneurysm Rupture Risk: A Comprehensive Review

Abstract

The current clinical management of abdominal aortic aneurysm (AAA) disease is based to a great extent on measuring the aneurysm maximum diameter to decide when timely intervention is required. Decades of clinical evidence show that aneurysm diameter is positively associated with the probability of rupture, but that other parameters may also play a role in causing or predisposing the AAA to rupture. Biological factors associated with smooth muscle apoptosis are implicated in AAA expansion while geometric and biomechanical factors identified by means of computational modeling techniques have been positively correlated with rupture risk with a higher accuracy and sensitivity than maximum diameter alone. The objective of this review is to examine the factors found to influence AAA disease progression, clinical management and rupture, as well as a patent review that highlights developments in this arena in the past few years.