Patient-Specific Clinical Assessment of Abdominal Aortic Aneurysm Rupture Risk based on its Geometric Parameters

Guillermo Vilalta, Félix Nieto, Carlos Vaquero, José A. Vilalta, and María Ángeles Pérez


AAA, Rupture risk prediction, Biomechanical factors


Abdominal aortic aneurysms (AAAs) rupture is one of the main causes of death in the world. This is a very complex phenomenon that usually occurs “without previous warning”. Currently, criteria to assess the aneurysm rupture risk (peak diameter and growth rate) can not be considered as reliable indicators. In order to improve the predicting of AAA rupture risk, the theoretical foundation of a simple method, where the main geometric parameters of aneurysms have been linked into six biomechanical factors, which have been combined to obtain a dimensionless rupture risk index, RI(t), is presented in this work. This quantitative indicator, which has been implemented in a tool, is easy to understand, it allows estimating the aneurysms rupture risks, it is expected to be able to identify the one that ruptures even when its peak diameter is less than the threshold value and identify those cases where the rupture should not occur and according to the maximum diameter, the patient is submitted to surgical procedure. The method was validated, preliminarily, with a clinical case and other three cases from the literature. Based on these initial results of the validation test, a broader prospective randomized control study has been carried out with two hundred and one patients at the Clinic Hospital of Valladolid-Spain, which were submitted to surgical repair treatment (EVAR). The results of this study shown that it is possible to carry out a clinical assessment of the AAA rupture risk through its geometric parameters and that the most important geometric biomechanical factors are the deformation rate and saccular index.

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