Finite element analysis in asymptomatic, symptomatic, and ruptured abdominal aortic aneurysms: in search of new rupture risk predictors.

Erhart, P; Hyhlik-Dürr, A; Geisbüsch, P; Kotelis, D; Müller-Eschner, M; Gasser, T C; von Tengg-Kobligk, Hendrik; Böckler, D (2015). Finite element analysis in asymptomatic, symptomatic, and ruptured abdominal aortic aneurysms: in search of new rupture risk predictors. European journal of vascular and endovascular surgery EJVES, 49(3), pp. 239-245. Elsevier 10.1016/j.ejvs.2014.11.010

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OBJECTIVES To compare biomechanical rupture risk parameters of asymptomatic, symptomatic and ruptured abdominal aortic aneurysms (AAA) using finite element analysis (FEA). STUDY DESIGN Retrospective biomechanical single center analysis of asymptomatic, symptomatic, and ruptured AAAs. Comparison of biomechanical parameters from FEA. MATERIALS AND METHODS From 2011 to 2013 computed tomography angiography (CTA) data from 30 asymptomatic, 15 symptomatic, and 15 ruptured AAAs were collected consecutively. FEA was performed according to the successive steps of AAA vessel reconstruction, segmentation and finite element computation. Biomechanical parameters Peak Wall Rupture Risk Index (PWRI), Peak Wall Stress (PWS), and Rupture Risk Equivalent Diameter (RRED) were compared among the three subgroups. RESULTS PWRI differentiated between asymptomatic and symptomatic AAAs (p < .0004) better than PWS (p < .1453). PWRI-dependent RRED was higher in the symptomatic subgroup compared with the asymptomatic subgroup (p < .0004). Maximum AAA external diameters were comparable between the two groups (p < .1355). Ruptured AAAs showed the highest values for external diameter, total intraluminal thrombus volume, PWS, RRED, and PWRI compared with asymptomatic and symptomatic AAAs. In contrast with symptomatic and ruptured AAAs, none of the asymptomatic patients had a PWRI value >1.0. This threshold value might identify patients at imminent risk of rupture. CONCLUSIONS From different FEA derived parameters, PWRI distinguishes most precisely between asymptomatic and symptomatic AAAs. If elevated, this value may represent a negative prognostic factor for asymptomatic AAAs.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

von Tengg-Kobligk, Hendrik

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1078-5884

Publisher:

Elsevier

Language:

English

Submitter:

Aisha Stefania Mzinga

Date Deposited:

01 May 2015 15:04

Last Modified:

05 Nov 2015 11:16

Publisher DOI:

10.1016/j.ejvs.2014.11.010

PubMed ID:

25542592

Uncontrolled Keywords:

Abdominal aortic aneurysm; Aorta; Finite element analysis (FEA); Rupture risk; Wall stress

BORIS DOI:

10.7892/boris.66781

URI:

https://boris.unibe.ch/id/eprint/66781

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