Journal
MEDICAL ENGINEERING & PHYSICS
Volume 38, Issue 6, Pages 526-537Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.medengphy.2016.03.003
Keywords
Abdominal aortic aneurysms; Finite element analysis; Patient-specific modelling; Patient-specific wall thickness; Rupture risk
Categories
Funding
- MA3RS clinical trial [NIHR EME 11/20/03]
- British Heart Foundation [CH/09/002]
- Wellcome Trust [WT103782AIA]
- Academic Department of Military Surgery and Trauma
- Medical Research Council [MC_PC_12040, G0701127] Funding Source: researchfish
- MRC [G0701127, MC_PC_12040] Funding Source: UKRI
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Rupture of abdominal aortic aneurysms (AAAs) is linked to aneurysm morphology. This study investigates the influence of patient-specific (PS) AAA wall thickness on predicted clinical outcomes. Eight patients under surveillance for AAAs were selected from the MA(3)RS clinical trial based on the complete absence of intraluminal thrombus. Two finite element (FE) models per patient were constructed; the first incorporated variable wall thickness from CT (PS_wall), and the second employed a 1.9 mm uniform wall (Uni_wall). Mean PS wall thickness across all patients was 1.77 +/- 0.42 mm. Peak wall stress (PWS) for PS_wall and Uni_wall models was 0.6761 +/- 0.3406 N/mm(2) and 0.4905 +/- 0.0850 N/mm(2), respectively. In 4 out of 8 patients the Uni_wall underestimated stress by as much as 55%; in the remaining cases it overestimated stress by up to 40%. Rupture risk more than doubled in 3 out of 8 patients when PS_wall was considered. Wall thickness influenced the location and magnitude of PWS as well as its correlation with curvature. Furthermore, the volume of the MA under elevated stress increased significantly in AAAs with higher rupture risk indices. This highlights the sensitivity of standard rupture risk markers to the specific wall thickness strategy employed. (C) 2016 IPEM. Published by Elsevier Ltd. All rights reserved.
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