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Open Access 10-03-2023 | Abdominal Aortic Aneurysm | Vascular-Interventional

Association between aortic peak wall stress and rupture index with abdominal aortic aneurysm–related events

Authors: Tejas P. Singh, Joseph V. Moxon, T. Christian Gasser, Jason Jenkins, Michael Bourke, Benard Bourke, Jonathan Golledge

Published in: European Radiology | Issue 8/2023

Abstract

Objective

The aim of this study was to assess whether aortic peak wall stress (PWS) and peak wall rupture index (PWRI) were associated with the risk of abdominal aortic aneurysm (AAA) rupture or repair (defined as AAA events) among participants with small AAAs.

Methods

PWS and PWRI were estimated from computed tomography angiography (CTA) scans of 210 participants with small AAAs (≥ 30 and ≤ 50 mm) prospectively recruited between 2002 and 2016 from two existing databases. Participants were followed for a median of 2.0 (inter-quartile range 1.9, 2.8) years to record the incidence of AAA events. The associations between PWS and PWRI with AAA events were assessed using Cox proportional hazard analyses. The ability of PWS and PWRI to reclassify the risk of AAA events compared to the initial AAA diameter was examined using net reclassification index (NRI) and classification and regression tree (CART) analysis.

Results

After adjusting for other risk factors, one standard deviation increase in PWS (hazard ratio, HR, 1.56, 95% confidence intervals, CI 1.19, 2.06; p = 0.001) and PWRI (HR 1.74, 95% CI 1.29, 2.34; p < 0.001) were associated with significantly higher risks of AAA events. In the CART analysis, PWRI was identified as the best single predictor of AAA events at a cut-off value of > 0.562. PWRI, but not PWS, significantly improved the classification of risk of AAA events compared to the initial AAA diameter alone.

Conclusion

PWS and PWRI predicted the risk of AAA events but only PWRI significantly improved the risk stratification compared to aortic diameter alone.

Key Points

• Aortic diameter is an imperfect measure of abdominal aortic aneurysm (AAA) rupture risk.

• This observational study of 210 participants found that peak wall stress (PWS) and peak wall rupture index (PWRI) predicted the risk of aortic rupture or AAA repair.

• PWRI, but not PWS, significantly improved the risk stratification for AAA events compared to aortic diameter alone.

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Title: Association between aortic peak wall stress and rupture index with abdominal aortic aneurysm–related events
Authors: Tejas P. Singh
Joseph V. Moxon
T. Christian Gasser
Jason Jenkins
Michael Bourke
Benard Bourke
Jonathan Golledge
Publication date: 10-03-2023
Publisher: Springer Berlin Heidelberg
Keywords: Abdominal Aortic Aneurysm
Abdominal Aortic Aneurysm
Peripheral Arterial Disease
CT Angiography
Peripheral Arterial Disease
Published in: European Radiology / Issue 8/2023
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-09488-1

2024 ASCO Annual Meeting

Springer Medicine

Association between aortic peak wall stress and rupture index with abdominal aortic aneurysm–related events

Abstract

Objective

Methods

Results

Conclusion

Key Points

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key Points

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