Early Prediction of Abdominal Aortic Aneurysm Rupture Risk Using Numerical Biomechanical Analysis.

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Medical Imaging Analysis

Background:

• Abdominal aortic aneurysm (AAA) rupture risk is primarily assessed by diameter and sex, necessitating improved predictive models.
• Understanding patient-specific biomechanical properties is crucial for predicting AAA growth and rupture.
• Current methods lack precision in identifying high-risk AAA cases for timely intervention.

Purpose of the Study:

• To predict patient-specific rupture risks and growth behaviors in abdominal aortic aneurysm (AAA) patients.
• To utilize biomechanical evaluation with finite element analysis (FEA) for AAA risk stratification.
• To establish an additional AAA repair threshold beyond diameter and sex.

Main Methods:

• A pseudo-prospective single-center study screened 1219 patients with conservative and repaired AAAs.
• Matched analysis of 15 ruptured AAAs (rAAA) versus 15 non-ruptured controls based on imaging, diameter, sex, and time.
• Biomechanical properties were analyzed using finite element method (FEA).

Main Results:

• Ruptured AAAs showed significantly higher peak wall stress (PWS) and luminal diameter compared to controls at initial and subsequent imaging.
• The rAAA group exhibited faster increases in PWS (nearly 10x) and luminal diameter (nearly 4x) per month.
• FEA revealed significant differences in biomechanical parameters, including PWS, luminal diameter, PWRR, and RRED, between ruptured and non-ruptured AAAs.

Conclusions:

• Finite element analysis of biomechanical properties can predict increased AAA rupture risk.
• Matched imaging analysis before and after AAA rupture confirmed the predictive capability of FEA.
• Further multicenter data are required to validate these findings and support clinical implementation.