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Comparative analysis between abdominal aortic aneurysm and popliteal artery aneurysm
Marcos Vinícius Melo de Oliveira1, Alexandre Malta Brandão1, Gina Camillo Rocha Silvestre1
1Vascular and Endovascular Division, Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil.
Jvs-Vascular Science
|February 13, 2025
Summary
Popliteal artery aneurysms (PAA) exhibit greater mechanical strength than abdominal aortic aneurysms (AAA). However, AAA walls show increased B lymphocytes and adipogenic differentiation in the adventitia, unlike PAA.
Area of Science:
- Vascular biology and biomechanics
- Histopathology and immunohistochemistry
- Aneurysm disease research
Background:
- Abdominal aortic aneurysms (AAA) and popliteal artery aneurysms (PAA) are distinct vascular conditions with different clinical outcomes.
- Understanding the underlying biomechanical and histological differences is crucial for targeted therapeutic strategies.
Purpose of the Study:
- To conduct a comprehensive comparative analysis of the biomechanical, histological, and immunohistochemical characteristics of AAA and PAA.
- To elucidate the distinct pathophysiological mechanisms contributing to the differing clinical presentations and outcomes of AAA and PAA.
Main Methods:
- Inclusion of 180 patients with AAA and 18 with PAA, with collection of medical history and imaging data.
- Biomechanical testing to evaluate arterial wall mechanical strength and elasticity.
- Histological and immunohistochemical analyses to examine tissue composition and inflammatory markers.
Main Results:
- Popliteal artery aneurysm (PAA) wall fragments demonstrated significantly higher failure strain energy (13.36 N/m² vs. 9.95 N/m²; P = .023), indicating greater mechanical strength.
- Abdominal aortic aneurysms (AAA) exhibited more B lymphocyte cells (CD20) in the adventitia (1475.50 vs. 320; P = .003) compared to PAA.
- AAA showed increased adventitial adipogenic differentiation (PPARgamma; P = .009), while PAA displayed prominent intimal adipogenic differentiation (KLF5; P = .039).
Conclusions:
- Popliteal artery aneurysms possess greater inherent mechanical strength compared to abdominal aortic aneurysms.
- Abdominal aortic aneurysms are characterized by a more pronounced inflammatory infiltrate (B lymphocytes) and adventitial adipogenic changes.
- Popliteal artery aneurysms show distinct patterns of adipogenic differentiation within the intima, differentiating them from AAA.
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