{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:38:42Z","timestamp":1788305922196,"version":"build-2803163510"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["ATVB"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n            <jats:title>Objective\u2014<\/jats:title>\n            <jats:p>Isolated common iliac artery aneurysms (CIAA) are rare. Their prognosis and influence on aortoiliac blood flow and remodeling are unclear. We evaluated the hypotheses that morphology at and distal to the aortic bifurcation, together with the associated hemodynamic changes, influence both the natural history of CIAA and proximal aortic remodeling.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results\u2014<\/jats:title>\n            <jats:p>\n              Twenty-five isolated CIAAs (15 intact, 10 ruptured), in 23 patients were reconstructed and analyzed with computational fluid dynamics: all showed abnormal flow. Then we studied a series of 24 hypothetical aortoiliac geometries in silico with varying abdominal aortic deflection and aortic bifurcation angles: key findings were assessed in an independent validation cohort of 162 patients. Wall shear stress in isolated unilateral CIAAs was lower than the contralateral common iliac artery, 0.38\u00b10.33 Pa versus 0.61\u00b10.24 Pa, inversely associated with CIAA diameter (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and morphology (high shear stress in variants distal to a sharp kink). Rupture usually occurred in regions of elevated low and oscillatory shear with a wide aortic bifurcation angle. Abdominal aortas deflected towards the CIAA for most unilateral isolated CIAAs (14\/21). In silico, wider bifurcation angles created high focal regions of low and oscillatory shear in the common iliac artery. The associations of unilateral CIAA with aortic deflection and common iliac artery diameter with bifurcation angle were confirmed in the validation cohort.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Decreasing wall shear stress is strongly associated with CIAA progression (larger aneurysms and rupture), whereas abnormal blood flow in the CIAA seems to promote proximal aortic remodeling, with adaptive lateral deflection of the abdominal aorta towards the aneurysmal side.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/atvbaha.119.312687","type":"journal-article","created":{"date-parts":[[2019,4,25]],"date-time":"2019-04-25T09:08:40Z","timestamp":1556183320000},"page":"1125-1136","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Morphology and Hemodynamics in Isolated Common Iliac Artery Aneurysms Impacts Proximal Aortic Remodeling"],"prefix":"10.1161","volume":"39","author":[{"given":"Louis P.","family":"Parker","sequence":"first","affiliation":[{"name":"From the Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research (L.P.P., L.J.K., B.L., P.E.N., B.J.D.), The University of Western Australia, Perth"},{"name":"School of Engineering (L.P.P., L.J.K., B.L., B.J.D.), The University of Western Australia, Perth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet T.","family":"Powell","sequence":"additional","affiliation":[{"name":"Vascular Surgery Research Group, Imperial College London, United Kingdom (J.T.P.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lachlan J.","family":"Kelsey","sequence":"additional","affiliation":[{"name":"From the Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research (L.P.P., L.J.K., B.L., P.E.N., B.J.D.), The University of Western Australia, Perth"},{"name":"School of Engineering (L.P.P., L.J.K., B.L., B.J.D.), The University of Western Australia, Perth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendon","family":"Lim","sequence":"additional","affiliation":[{"name":"From the Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research (L.P.P., L.J.K., B.L., P.E.N., B.J.D.), The University of Western Australia, Perth"},{"name":"School of Engineering (L.P.P., L.J.K., B.L., B.J.D.), The University of Western Australia, Perth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Ashleigh","sequence":"additional","affiliation":[{"name":"University Hospital of South Manchester, United Kingdom (R.A.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarit","family":"Venermo","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Helsinki University Central Hospital, Finland (M.V.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Koncar","sequence":"additional","affiliation":[{"name":"Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia (I.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul E.","family":"Norman","sequence":"additional","affiliation":[{"name":"From the Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research (L.P.P., L.J.K., B.L., P.E.N., B.J.D.), The University of Western Australia, Perth"},{"name":"Medical School (P.E.N.), The University of Western Australia, Perth"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry J.","family":"Doyle","sequence":"additional","affiliation":[{"name":"From the Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research (L.P.P., L.J.K., B.L., P.E.N., B.J.D.), The University of Western Australia, Perth"},{"name":"School of Engineering (L.P.P., L.J.K., B.L., B.J.D.), The University of Western Australia, Perth"},{"name":"Australian Research Council Centre for Personalised Therapeutics Technologies (B.J.D.)"},{"name":"BHF Centre for Cardiovascular Science, The University of Edinburgh, United Kingdom (B.J.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","first-page":"688","article-title":"Isolated iliac artery aneurysms.","volume":"93","author":"McCready RA","year":"1983","unstructured":"McCready, RA, Pairolero, PC, Gilmore, JC, Kazmier, FJ, Cherry, KJ, Jr, Hollier, LH. 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