Abstract
I thank Dr. Georgakarakos and colleagues for their letter in response to our article. We attempted to predict AAA growth based on relative wall stress. We found a lower growth rate for the group of AAAs with a relative low wall stress.1Speelman L. Hellenthal FA. Pulinx B. Bosboom E.M. Breeuwer M. van Sambeek M.R. et al.The influence of wall stress on AAA growth and biomarkers.Eur J Vasc Endovasc Surg. 2010; 39: 410-416Google Scholar However, AAA growth is most likely a multifactorial phenomenon, possibly including the effects of flow through the AAA. It is known that AAAs grow faster when they increase in size. Also the amount of thrombus grows, narrowing the flow lumen to a comparable size as the healthy aorta, only the flow lumen is more tortuous in AAAs. Additionally, the endothelial cells normally covering the vessel wall are destroyed and can therefore not respond to shear stresses induced by secondary flows. Our group previously developed FSI models of AAAs2Wolters B.J. Rutten M.C. Schurink G.W. Kose U. de Hart J. van de Vosse F.N. et al.A patient-specific computational model of fluid-structure interaction in abdominal aortic aneurysms.Med Eng Phys. 2005; 27: 871-883Google Scholar and, among others, we will further investigate the relation between aneurysmal flow, thrombus and AAA growth. Additionally we will evaluate these models to study the relation between wall stress, flow effects, circulating biomarkers and AAA growth in a larger patient population. Comment on “The Influence of Wall Stress on AAA Growth and Biomarkers”European Journal of Vascular and Endovascular SurgeryVol. 39Issue 6PreviewWe read with great interest the article by Speelman et al., which combines information about wall stress and circulating biomarkers, related to AAA growth rate. The results suggested no correlation between stress values and biomarkers.1 Growth rate of the low stress group was significantly lower than that of the medium stress, despite the fact that this difference was not large between low and high stress groups. Full-Text PDF Open Archive
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