A Comparison of Diameter, Wall Stress, and Rupture Potential Index for Abdominal Aortic Aneurysm Rupture Risk Prediction
A Comparison of Diameter, Wall Stress, and Rupture Potential Index for Abdominal Aortic Aneurysm Rupture Risk Prediction
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DOI：
10.1007/s10439-010-0067-6
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发表时间：
2010-10-01
影响因子：
3.8
通讯作者：
Wall, W. A.
中科院分区：
文献类型：
--
作者：
Maier, A.;Gee, M. W.;Wall, W. A.
腹主动脉瘤（AAA）是主动脉的球囊样扩张，在破裂的情况下可能是致命的。计算有限元（FE）分析是一种有前途的方法，可以更准确地预测患者特定的破裂风险。AAA壁强度和破裂潜力指数（RPI）计算在我们的有限元软件中实现。对n = 30例无症状非破裂、n = 9例有症状非破裂和n = 14例破裂AAA进行静态结构FE模拟。我们计算每个AAA的直径、壁位移、应变、应力和RPI的最大值以及最小壁强度。除最小强度外，所有研究数量均显示非破裂无症状和有症状/破裂AAA之间存在统计学显著差异。有症状和破裂的AAA的最大壁应力，特别是RPI显着增加。发现最大的差异是RPI（Delta = 44.9%，p = 8.0e-5）。有症状或破裂AAA的最低RPI为0.3。超过55%的调查的无症状AAA福尔斯的RPI低于该值。最大壁应力和最大RPI标准能够对AAA进行可靠的破裂风险评估。特别是在手术指征不明显的直径范围内，RPI具有改善临床决策的巨大潜力。
An abdominal aortic aneurysm (AAA) is a balloon-like dilation of the aorta, which is potentially fatal in case of rupture. Computational finite element (FE) analysis is a promising approach to a more accurate and patient-specific rupture risk prediction. AAA wall strength and rupture potential index (RPI) calculation are implemented in our FE software. Static structural FE simulations are performed on n = 30 non-ruptured asymptomatic, n = 9 non-ruptured symptomatic, and n = 14 ruptured AAAs. We calculate maximum values for diameter, wall displacement, strain, stress, and RPI as well as minimum wall strength for every AAA. All investigated quantities, except minimum strength, show statistically significant differences between non-ruptured asymptomatic and symptomatic/ruptured AAAs. Maximum wall stress and especially the RPI are notably increased for symptomatic and ruptured AAAs. The biggest difference is found to be the RPI (Delta = 44.9%, p = 8.0e-5). Lowest RPI obtained for symptomatic or ruptured AAAs is 0.3. The RPI of more than 55% of the investigated asymptomatic AAAs falls below this value. Maximum wall stress and maximum RPI criteria enable a reliable rupture risk evaluation for AAAs. Especially in the diameter range where surgical indication is not obvious, the RPI holds great potential for improvement of clinical decisions.