On growth, buckling, and rupture of aneurysms

TL;DR

This study investigates why some buckled aneurysms do not rupture despite exceeding recommended sizes by combining experiments and finite element modeling, revealing the influence of arterial mechanics and buckling behavior.

Contribution

It introduces a comprehensive failure map integrating buckling, bulging, and rupture regimes using experimental data and advanced material modeling.

Findings

Buckled aneurysms can grow larger without rupturing under certain pre-tensions.

Stretch reversal influences whether buckling or bulging occurs first.

Exponential stiffening promotes axial growth over radial expansion.

Abstract

Aneurysms are localized bulges of arteries, and they can rupture with fatal consequences. Complex mechanobiological factors preclude in vivo testing to assess the rupture risk of an aneurysm, and size based criteria are often used in clinical practice to guide surgical interventions. It is often found that tortuous and buckled aneurysms can exceed in size recommended for surgical intervention, and yet do not rupture. This study addresses why buckled aneurysms exhibit this intriguing behaviour by combining in vitro inflation experiments on hyperelastic tubes with finite element calculations. Using a biologically relevant material model for an arterial wall, we show that buckled aneurysms can grow in size without rupturing under favourable arterial pre-tensions. Stretch reversal phenomenon exhibited by arteries governs whether buckling or bulging occurs first. Exponential stiffening favours the axial propagation of an aneurysm instead of radial growth in size. The choice of failure criteria based on Ogden's strain energy function, Gent's first stretch invariant, and Cauchy stress are discussed. Failure maps incorporating post bifurcation (bulging and buckling) response are constructed to delineate the regimes of growth, buckling and rupture of an aneurysm.