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

José Augusto Tavares Monteiro; Erasmo Simão da Silva; Madhavan L Raghavan; Pedro Puech-Leão; Maria de Lourdes Higuchi; José Pinhata Otoch

doi:10.1016/j.jvs.2013.04.064

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

Journal article

Open access

Peer reviewed

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

José Augusto Tavares Monteiro, Erasmo Simão da Silva, Madhavan L Raghavan, Pedro Puech-Leão, Maria de Lourdes Higuchi and José Pinhata Otoch

Journal of vascular surgery, Vol.59(5), pp.1393-1401.e2

05/2014

DOI: 10.1016/j.jvs.2013.04.064

PMID: 23891493

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Abstract

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. 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. 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/cm(2); 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 <5.5 cm and <5.5 cm, but more intense inflammatory activity was seen in larger AAA (grade 3; 70% × 28.6%; P = .011). Compared with asymptomatic aneurysms, symptomatic aneurysms showed no differences in the biomechanical failure properties (strength, 5.32 ± 2.36 × 4.65 ± 2.05 N; P = .155; tension, 14.08 ± 6.11 × 12.81 ± 5.77 N/cm; P = .154; stress, 103.02 × 84.76 N/cm(2); P = .144), strain (0.38 ± 0.12 × 0.41 ± 0.13; P = .287), thickness of the fragments (1.56 ± 0.41 × 1.57 ± 0.41 mm; P = .848), and histologic composition (collagen fibers, 44.67 ± 11.17 × 44.02 ± 13.79%; P = .808; smooth muscle fibers, 2.52 × 2.35%; P = .751; elastic fibers, <1%) Fragments of the anterior wall from larger aneurysms were more resistant than those from smaller AAA, with no tissue properties that could explain this phenomenon in the histologic or histochemical analyses utilized. The fragments of the anterior midsection from larger aneurysms were more resistant than those from smaller abdominal aortic aneurysms, with no tissue properties that could explain this phenomenon in the histologic or histochemical analyses. Larger aneurysms, at least in this place may be stronger than smaller aneurysms. It could point toward regional differences (heterogeneity, localized pathologies) as an important player in aneurysm rupture. Uniaxial strain tests are an important tool for the comprehension of a complex behavior such as that from an aneurysmal aortic wall. However, these tests still have limitations in providing information that would allow the calculation of the risk of rupture for abdominal aortic aneurysms.

Tensile Strength

Fibrillar Collagens - analysis

Inflammation - pathology

Prospective Studies

Aortic Aneurysm, Abdominal - surgery

Aortic Rupture - etiology

Aortic Aneurysm, Abdominal - complications

Humans

Risk Factors

Myocytes, Smooth Muscle - pathology

Elasticity

Stress, Mechanical

Aortic Rupture - pathology

Male

Aortic Aneurysm, Abdominal - metabolism

Elastic Tissue - pathology

Biomechanical Phenomena

Aorta, Abdominal - chemistry

Brazil

Female

Aorta, Abdominal - pathology

Aorta, Abdominal - surgery

Vascular Stiffness

Aortic Aneurysm, Abdominal - pathology

Details

Title: Subtitle: Histologic, histochemical, and biomechanical properties of fragments isolated from the anterior wall of abdominal aortic aneurysms
Creators: José Augusto Tavares Monteiro - Department of Surgery, Vascular and Endovascular Division and Surgical Technique Division, University of São Paulo Medical School, São Paulo, Brazil. Electronic address: zautmonteiro@uol.com.br
Erasmo Simão da Silva - Department of Surgery, Vascular and Endovascular Division and Surgical Technique Division, University of São Paulo Medical School, São Paulo, Brazil
Madhavan L Raghavan - Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa
Pedro Puech-Leão - Department of Surgery, Vascular and Endovascular Division and Surgical Technique Division, University of São Paulo Medical School, São Paulo, Brazil
Maria de Lourdes Higuchi - Department of Surgery, Vascular and Endovascular Division and Surgical Technique Division, University of São Paulo Medical School, São Paulo, Brazil
José Pinhata Otoch - Department of Surgery, Vascular and Endovascular Division and Surgical Technique Division, University of São Paulo Medical School, São Paulo, Brazil
Resource Type: Journal article
Publication Details: Journal of vascular surgery, Vol.59(5), pp.1393-1401.e2
DOI: 10.1016/j.jvs.2013.04.064
PMID: 23891493
NLM abbreviation: J Vasc Surg
ISSN: 0741-5214
eISSN: 1097-6809
Publisher: United States
Language: English
Date published: 05/2014
Academic Unit: Roy J. Carver Department of Biomedical Engineering
Record Identifier: 9984064593602771

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