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Predictors of Abdominal Aortic Aneurysm Risks

Computational biomechanics via finite element analysis (FEA) has long promised a means of assessing patient-specific abdominal aortic aneurysm (AAA) rupture risk with greater efficacy than current clinically used size-based criteria. The pursuit stems from the notion that AAA rupture occurs when wal...

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Autores principales: Haller, Stephen J., Azarbal, Amir F., Rugonyi, Sandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552640/
https://www.ncbi.nlm.nih.gov/pubmed/32707846
http://dx.doi.org/10.3390/bioengineering7030079
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author Haller, Stephen J.
Azarbal, Amir F.
Rugonyi, Sandra
author_facet Haller, Stephen J.
Azarbal, Amir F.
Rugonyi, Sandra
author_sort Haller, Stephen J.
collection PubMed
description Computational biomechanics via finite element analysis (FEA) has long promised a means of assessing patient-specific abdominal aortic aneurysm (AAA) rupture risk with greater efficacy than current clinically used size-based criteria. The pursuit stems from the notion that AAA rupture occurs when wall stress exceeds wall strength. Quantification of peak (maximum) wall stress (PWS) has been at the cornerstone of this research, with numerous studies having demonstrated that PWS better differentiates ruptured AAAs from non-ruptured AAAs. In contrast to wall stress models, which have become progressively more sophisticated, there has been relatively little progress in estimating patient-specific wall strength. This is because wall strength cannot be inferred non-invasively, and measurements from excised patient tissues show a large spectrum of wall strength values. In this review, we highlight studies that investigated the relationship between biomechanics and AAA rupture risk. We conclude that combining wall stress and wall strength approximations should provide better estimations of AAA rupture risk. However, before personalized biomechanical AAA risk assessment can become a reality, better methods for estimating patient-specific wall properties or surrogate markers of aortic wall degradation are needed. Artificial intelligence methods can be key in stratifying patients, leading to personalized AAA risk assessment.
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spelling pubmed-75526402020-10-14 Predictors of Abdominal Aortic Aneurysm Risks Haller, Stephen J. Azarbal, Amir F. Rugonyi, Sandra Bioengineering (Basel) Review Computational biomechanics via finite element analysis (FEA) has long promised a means of assessing patient-specific abdominal aortic aneurysm (AAA) rupture risk with greater efficacy than current clinically used size-based criteria. The pursuit stems from the notion that AAA rupture occurs when wall stress exceeds wall strength. Quantification of peak (maximum) wall stress (PWS) has been at the cornerstone of this research, with numerous studies having demonstrated that PWS better differentiates ruptured AAAs from non-ruptured AAAs. In contrast to wall stress models, which have become progressively more sophisticated, there has been relatively little progress in estimating patient-specific wall strength. This is because wall strength cannot be inferred non-invasively, and measurements from excised patient tissues show a large spectrum of wall strength values. In this review, we highlight studies that investigated the relationship between biomechanics and AAA rupture risk. We conclude that combining wall stress and wall strength approximations should provide better estimations of AAA rupture risk. However, before personalized biomechanical AAA risk assessment can become a reality, better methods for estimating patient-specific wall properties or surrogate markers of aortic wall degradation are needed. Artificial intelligence methods can be key in stratifying patients, leading to personalized AAA risk assessment. MDPI 2020-07-22 /pmc/articles/PMC7552640/ /pubmed/32707846 http://dx.doi.org/10.3390/bioengineering7030079 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Haller, Stephen J.
Azarbal, Amir F.
Rugonyi, Sandra
Predictors of Abdominal Aortic Aneurysm Risks
title Predictors of Abdominal Aortic Aneurysm Risks
title_full Predictors of Abdominal Aortic Aneurysm Risks
title_fullStr Predictors of Abdominal Aortic Aneurysm Risks
title_full_unstemmed Predictors of Abdominal Aortic Aneurysm Risks
title_short Predictors of Abdominal Aortic Aneurysm Risks
title_sort predictors of abdominal aortic aneurysm risks
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552640/
https://www.ncbi.nlm.nih.gov/pubmed/32707846
http://dx.doi.org/10.3390/bioengineering7030079
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