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Biomechanical Characterization of Internal Layer Subfailure in Blunt Arterial Injury

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Abstract

Blunt carotid artery injuries occur in 0.3% of blunt injured patients and may lead to devastating neurological consequences. However, arterial mechanics leading to internal layer subfailure have not been quantified. Twenty-two human carotid artery segments and 18 porcine thoracic aorta segments were opened to expose the intimal side and longitudinally distracted to failure. Porcine aortas were a geometrically accurate model of human carotid arteries. Internal layer subfailures were identified using videography and correlated with mechanical data. Ninety-three percent (93%) of vessels demonstrated subfailure prior to catastrophic failure. All subfailures occurred on the intimal surface. Initial subfailure occurred at 79% of the stress and 85% of the strain to catastrophic failure in younger porcine specimens, compared to 44% and 60%, respectively, in older human specimens. In most cases, multiple subfailures occurred prior to catastrophic failure. Due to limitations in human specimen quality (age, prior storage), young and fresh porcine aorta specimens are likely a more accurate model of clinical blunt carotid artery injuries. Present results indicate that vessels are acutely capable of maintaining physiologic function following initial subfailure. Delayed symptomatology commonly associated with blunt arterial injuries is explained by this mechanics-based and experimentally quantified onset of subcatastrophic failure.

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Acknowledgments

This research was supported in part by the Department of Veterans Affairs Medical Research. The funding for this research has also been provided in part by an Australian Research Council linkage grant and by private parties, who have selected Dr. Kennerly Digges and FHWA/NHTSA National Crash Analysis Center at the George Washington University to be an independent solicitor of and funder for research in motor vehicle safety, and to be one of the peer reviewers for the research projects and reports. Neither of the private parties have determined the allocation of funds or had any influence on the content of this report.

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  1. Department of Neurosurgery, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI, 53226, USA

    Brian D. Stemper, Narayan Yoganandan, Grant P. Sinson, Thomas A. Gennarelli, Michael R. Stineman & Frank A. Pintar

  2. Department of Veterans Affairs Medical Center, Milwaukee, WI, USA

    Brian D. Stemper, Narayan Yoganandan, Grant P. Sinson, Thomas A. Gennarelli, Michael R. Stineman & Frank A. Pintar

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  1. Brian D. Stemper
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Stemper, B.D., Yoganandan, N., Sinson, G.P. et al. Biomechanical Characterization of Internal Layer Subfailure in Blunt Arterial Injury. Ann Biomed Eng 35, 285–291 (2007). https://doi.org/10.1007/s10439-006-9229-y

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