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Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index
KTH, School of Engineering Sciences (SCI), Solid Mechanics (Dept.), Solid Mechanics (Div.).
2015 (English)In: Journal of the Royal Society Interface, ISSN 1742-5689, E-ISSN 1742-5662, Vol. 12, no 113, 20150852Article in journal (Refereed) PublishedText
Abstract [en]

A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach.

Place, publisher, year, edition, pages
Royal Society Publishing , 2015. Vol. 12, no 113, 20150852
Keyword [en]
abdominal aortic aneurysm, uncertainty, model finite element, failure, wall stress
National Category
Engineering and Technology
Identifiers
URN: urn:nbn:se:kth:diva-181384DOI: 10.1098/rsif.2015.0852ISI: 000367807000016ScopusID: 2-s2.0-84954141217OAI: oai:DiVA.org:kth-181384DiVA: diva2:900258
Note

QC 20160203

Available from: 2016-02-03 Created: 2016-02-01 Last updated: 2016-02-03Bibliographically approved

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Gasser, T. Christian
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