Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury.

Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury. Research Abstract Details 

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Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury. Abstract Text:

Janice J Yeung,Hyun Jin Kim,Thomas A Abbruzzese,Irene E Vignon-Clementel,Mary T Draney-Blomme,Kay K Yeung,Inder Perkash,Robert J Herfkens,Charles A Taylor,Ronald L Dalman,

BACKGROUND: Reduced lower limb blood flow and resistive hemodynamic conditions potentially promote aortic inflammation and aneurysmal degeneration. We used abdominal ultrasonography, magnetic resonance imaging, and computational flow modeling to determine the relationship between reduced infrarenal aortic blood flow in chronic spinal cord injury (SCI) subjects and risk for abdominal aortic aneurysm (AAA) disease. METHODS: Aortic diameter in consecutive SCI subjects (n = 123) was determined via transabdominal ultrasonography. Aortic anatomic and physiologic data were acquired via magnetic resonance angiography (MRA; n = 5) and cine phase-contrast magnetic resonance flow imaging (n = 4) from SCI subjects whose aortic diameter was less than 3.0 cm by ultrasonography. Computational flow models were constructed from magnetic resonance data sets. Results were compared with those obtained from ambulatory control subjects (ultrasonography, n = 129; MRA/phase-contrast magnetic resonance flow imaging, n = 6) who were recruited at random from a larger pool of risk factor-matched individuals without known AAA disease. RESULTS: Age, sex distribution, and smoking histories were comparable between the SCI and control groups. In the SCI group, time since injury averaged 26 +/- 13 years (mean +/- SD). Aortic diameter was larger (P < .01), and the prevalence of large (> or = 2.5 cm; P < .01) or aneurysmal (> or = 3.0 cm; P < .05) aortas was greater in SCI subjects. Paradoxically, common iliac artery diameters were reduced in SCI subjects (< 1.0 cm; 48% SCI vs 26% control; P < .0001). Focal preaneurysmal enlargement was noted in four of five SCI subjects by MRA. Flow modeling revealed normal flow volume, biphasic and reduced oscillatory flow, slower pressure decay, and reduced wall shear stress in the SCI infrarenal aorta. CONCLUSIONS: Characteristic aortoiliac hemodynamic and morphologic adaptations occur in response to chronic SCI. Slower aortic pressure decay and reduced wall shear stress after SCI may contribute to mural degeneration, enlargement, and an increased prevalence of AAA disease.

Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury. Publishing Authors By Initials

JJ Yeung,HJ Kim,TA Abbruzzese,IE Vignon-Clementel,MT Draney-Blomme,KK Yeung,I Perkash,RJ Herfkens,CA Taylor,RL Dalman,

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Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: Journal of vascular surgery : official publication

VOLUME: 44

Page Numbers: 1254-1265

Journal Abbreviation: J. Vasc. Surg.

ISSN: 0741-5214

DAY: 3

MONTH: Dec

YEAR: 2006

Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury. Information

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LANGUAGE: eng

NlmUniqueID: 8407742

Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury. Keywords Mesh Terms:

KEYWORDS: Veterans

MESH TERMS: ultrasonography

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Grant and Affiliation Information for Aortoiliac hemodynamic and morphologic adaptation to chronic spinal cord injury.

AFFILIATION: Department of Surgery, University of Rochester, Rochester, NY, USA.

Country: United States

AGENCY: United States NHLBI

GRANT: R01 HL064338-05A2

ACRONYM: HL

MEDLINETA: J Vasc Surg

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