Publication detail

Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index

POLZER, S. GASSER, T.

Original Title

Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index

Type

journal article in Web of Science

Language

English

Original Abstract

Background. 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. Methods. The present 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. Results. Computed PRRI at 1.5 Mean Arterial Pressure was significantly (p=0.041) higher in ruptured AAAs (20.21(SD14.15%) than in intact AAAs (3.71(SD 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 (PWS) had only negligible effects on PRRI computations. Conclusion. 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 modeling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach.

Keywords

abdominal aortic aneurysm; uncertainty; model finite element; failure; wall stress;

Authors

POLZER, S.; GASSER, T.

RIV year

2015

Released

2. 12. 2015

Publisher

Royal Society Publishing

Location

London, Great Britain

ISBN

1742-5689

Periodical

Journal of the Royal Society Interface

Year of study

113

Number

12

State

United Kingdom of Great Britain and Northern Ireland

Pages from

1

Pages to

11

Pages count

11

URL

http://rsif.royalsocietypublishing.org/content/12/113/20150852

BibTex

@article{BUT118969,
  author="Stanislav {Polzer} and Thomas Christian {Gasser}",
  title="Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index",
  journal="Journal of the Royal Society Interface",
  year="2015",
  volume="113",
  number="12",
  pages="1--11",
  doi="10.1098/rsif.2015.0852",
  issn="1742-5689",
  url="http://rsif.royalsocietypublishing.org/content/12/113/20150852"
}