Abdominal aortic aneurysm volume and relative intraluminal thrombus volume might be auxiliary predictors of rupture-an observational cross-sectional study.

Objectives: The study aimed to identify differences and compare anatomical and biomechanical features between elective and ruptured abdominal aortic aneurysms (AAAs). Methods: Data (clinical, anatomical, and biomechanical) of 98 patients with AAA, 75 (76.53%) asymptomatic (Group aAAA) and 23 (23.46%) ruptured AAA (Group rAAA), were prospectively collected and analyzed. Anatomical, morphological, and biomechanical imaging markers like peak wall stress (PWS) and rupture risk equivalent diameter (RRED), comorbid conditions, and demographics were compared between the groups. Biomechanical features were assessed by analysis of Digital Imaging and Communication in Medicine images by A4clinics (Vascops), and anatomical features were assessed by 3Surgery (Trimensio). Binary and multiple logistic regression analysis were used and adjusted for confounders. Accuracy was assessed using receiving operative characteristic (ROC) curve analysis. Results: In a multivariable model, including gender and age as confounder variables, maximal aneurysm diameter [MAD, odds ratio (OR) = 1.063], relative intraluminal thrombus (rILT, OR = 1.039), and total aneurysm volume (TAV, OR = 1.006) continued to be significant predictors of AAA rupture with PWS (OR = 1.010) and RRED (OR = 1.031). Area under the ROC curve values and correct classification (cc) for the same parameters and the model that combines MAD, TAV, and rILT were measured: MAD (0.790, cc = 75%), PWS (0.713, cc = 73%), RRED (0.717, cc = 55%), TAV (0.756, cc = 79%), rILT (0.656, cc = 60%), and MAD + TAV + rILT (0.797, cc = 82%). Conclusion: Based on our results, in addition to MAD, other important predictors of rupture that might be used during aneurysm surveillance are TAV and rILT. Biomechanical parameters (PWS, RRED) as valuable predictors should be assessed in prospective clinical trials. Similar studies on AAA smaller than 55 mm in diameter, even difficult to organize, would be of even greater clinical value.

[Topographic localisation of insertion of the anterior cruciate ligament].

INTRODUCTION: Determining the center of tibial insertion of the anterior cruciate ligament is important during reconstruction ligament. AIM: Determining the center of insertion of the anterior cruciate ligament on the anterior intercondylar area relate to anterior and medial edge of the upper end of tibia. MATERIAL AND METHODS: The messurement has been done on 102 tibia. We measured distance from the center of ACL to anterior and medial edge of the uper part of tibia, and the lenght and the width of the tibial insetion. Also, we showed the procentual ratio these distances with medio-lateral and anteroposterior diametar of upper tibial part. RESULTS: The distance between the centre of attachment and medial edge is at 39% from entire latero-medial diametar, while the distance from anterior edge is at 31% from entire anterio-posterior diametar. The possitive correlation between the distance of centar of the anterior cruciate ligament from anterior and inner edge (r = 0.366, p) was found. CONCLUSION: The center of the attachment of the ACL at anterior intercondylarl area is at 1/3 of antero-posterial diametar behind the anterior edge of the upper part of tibia and 2/5 of latero-medial diametar inside from the medial edge.

[Correlation between femur's length and morphometric parameters of distal femur important in rupture anterior cruciate ligament].

INTRODUCTION: Frequency of anterior cruciate ligament rupture depends of anatomical parameters of distal femur and intercondylar notch. PURPOSE: Purpose of this work is identification relation between femur length and morphometrical parameters intecondylar notch, measuring in two levels. METHOD: A hundred femur's (medley population of 48 right and 52 left femurs), from osteological collection Department of Anatomy "Dr. Niko Miljanic" in Belgrade measured. Measurement was in two levels. Epicondilar width, width of medial and lateral condyls and intercondylar width, had been measured in level of popliteal sulcus and on the widest place, after that notch width index had been determinated. RESULTS: Absolute values of morphometrical parameters distal femur's are in positive relation with her length (p < 0.01), but notch width index is not, as in level of popliteal sulcus, as on the widest place (p > 0.05). CONCLUSION: Femur's length increasing also produces increasing of absolute anatomical parametars of distal femur which can produce rupture of anterior cruciate ligament, while relative dimensions do not show femur's length increasing.