Growth of aneurysms can be understood as passive yield to blood pressure

Abstract

The strength of aneurysm walls obtained intraoperatively or at autopsy immediately after death was evaluated by measurements of the force response to one-directional stretch and compared to the walls of intracranial arteries. The maximum stress that aneurysm tissue could tolerate was found slightly lower than in arteries, which is most probably due to the amount of immature forms of collagen. The stress resistance of aneurysms and arterial tissue decayed over a period of several hours. The relaxation curve could be approximated by the sum of 2 exponential terms. The half decay times of these terms were found identical in aneurysms and arteries, they appear to be collagen characteristics. The strength measured in vitro was compared to the stress in vivo, which was calculated on the basis of blood pressure and aneurysm radius. The stress tolerated by aneurysm walls over a period of 24 hours was found to be in the range of the stress that is imposed in vivo by the mean blood pressure. Arteries resisted stresses corresponding to pressures 10 to 20 times higher than physiological values. The thickness of the aneurysm walls correlated with the aneurysm radius in a linear fashion. It is suggested that aneurysm growth can be understood as passive yield to blood pressure, and reactive healing and thickening of the wall with increasing aneurysm diameter.