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AAA Rupture Risk Assessment in the Clinic: Wall Stress or Geometric Characterization?

[+] Author Affiliations
Ender A. Finol

University of Texas at San Antonio, San Antonio, TX

Samarth S. Raut, Kibaek Lee, Judy Shum

Carnegie Mellon University, Pittsburgh, PA

Satish C. Muluk

Allegheny General Hospital, Pittsburgh, PA

Mark K. Eskandari

Northwestern University, Chicago, IL

Ankur Chandra

University of Rochester, Rochester, NY

Paper No. SBC2013-14837, pp. V01AT01A006; 2 pages
doi:10.1115/SBC2013-14837
From:
  • ASME 2013 Summer Bioengineering Conference
  • Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotransport Phenomena; Bone, Joint and Spine Mechanics; Brain Injury; Cardiac Mechanics; Cardiovascular Devices, Fluids and Imaging; Cartilage and Disc Mechanics; Cell and Tissue Engineering; Cerebral Aneurysms; Computational Biofluid Dynamics; Device Design, Human Dynamics, and Rehabilitation; Drug Delivery and Disease Treatment; Engineered Cellular Environments
  • Sunriver, Oregon, USA, June 26–29, 2013
  • Conference Sponsors: Bioengineering Division
  • ISBN: 978-0-7918-5560-7
  • Copyright © 2013 by ASME

abstract

The current clinical management of abdominal aortic aneurysm (AAA) disease is based to a great extent on measuring the aneurysm maximum diameter to decide when timely intervention is required. Decades of clinical evidence show that aneurysm diameter is positively associated with the risk of rupture, but other parameters may also play a role in causing or predisposing the AAA to rupture. Geometric factors such as vessel tortuosity, intraluminal thrombus volume, and wall surface area are implicated in the differentiation of ruptured and unruptured AAAs. Biomechanical factors identified by means of computational modeling techniques, such as peak wall stress, have been positively correlated with rupture risk with a higher accuracy and sensitivity than maximum diameter alone. In the present work, we performed a controlled study targeted at evaluating the effect of uncertainty of the constitutive material model used for the vascular wall in the ensuing peak wall stress. Based on the outcome of this study, a second analysis was conducted based on the geometric characterization of surface curvature in two groups of aneurysm geometries, to discern which curvature metric can adequately discriminate ruptured from electively repaired AAA. The outcome of this work provides preliminary evidence on the importance of quantitative geometry characterization for AAA rupture risk assessment in the clinic.

Copyright © 2013 by ASME

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