Abdominal Aortic Aneurysm Biomechanics

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Abdominal aortic aneurysms (AAA) are localized dilations of the aorta that develop due to complex biomechanical and pathophysiological mechanisms. Aging and arterial remodeling contribute to the weakening of the aortic wall, increasing susceptibility to aneurysm formation and rupture. The primary risk factors include age, male sex, smoking, hypertension, and genetic predisposition. The most feared complication of AAA is rupture, which carries a high mortality rate, often exceeding 80%. Current clinical guidelines rely on aneurysm diameter and growth rate to indicate surgical repair; however, these criteria alone are insufficient to predict rupture risk accurately. Biomechanical analyses provide a deeper understanding of AAA progression. The arterial wall is a nonlinear, anisotropic, and viscoelastic structure, where collagen and elastin fibers play crucial roles in mechanical stability. Uniaxial tensile testing, finite element analysis, and computational fluid dynamics help assess wall stress distribution and predict failure points. The presence of intraluminal thrombus also influences aneurysm behavior, altering hemodynamics and mechanical resistance. Despite advancements, identifying reliable rupture predictors remains challenging. Integrating biomechanical models with clinical parameters could improve risk stratification and guide individualized treatment strategies. This chapter explores the biomechanics of AAA, highlighting the interplay between structural integrity, hemodynamics, and rupture risk assessment.

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