Biomechanical Assessment Predicts Aneurysm Related Events in Patients with Abdominal Aortic Aneurysm
To test whether aneurysm biomechanical ratio (ABR; a dimensionless ratio of wall stress and wall strength) can predict aneurysm related events. In a prospective multicentre clinical study of 295 patients with an abdominal aortic aneurysm (AAA; diameter ≥ 40 mm), three dimensional reconstruction and...
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| Veröffentlicht in: | European journal of vascular and endovascular surgery 2020-09, Vol.60 (3), p.365-373 |
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| creator | Doyle, Barry J. Bappoo, Nikhilesh Syed, Maaz B.J. Forsythe, Rachael O. Powell, Janet T. Conlisk, Noel Hoskins, Peter R. McBride, Olivia M.B. Shah, Anoop S.V. Norman, Paul E. Newby, David E. |
| description | To test whether aneurysm biomechanical ratio (ABR; a dimensionless ratio of wall stress and wall strength) can predict aneurysm related events.
In a prospective multicentre clinical study of 295 patients with an abdominal aortic aneurysm (AAA; diameter ≥ 40 mm), three dimensional reconstruction and computational biomechanical analyses were used to compute ABR at baseline. Participants were followed for at least two years and the primary end point was the composite of aneurysm rupture or repair.
The majority were male (87%), current or former smokers (86%), most (72%) had hypertension (mean ± standard deviation [SD] systolic blood pressure 140 ± 22 mmHg), and mean ± SD baseline diameter was 49.0 ± 6.9 mm. Mean ± SD ABR was 0.49 ± 0.27. Participants were followed up for a mean ± SD of 848 ± 379 days and rupture (n = 13) or repair (n = 102) occurred in 115 (39%) cases. The number of repairs increased across tertiles of ABR: low (n = 24), medium (n = 34), and high ABR (n = 44) (p = .010). Rupture or repair occurred more frequently in those with higher ABR (log rank p = .009) and ABR was independently predictive of this outcome after adjusting for diameter and other clinical risk factors, including sex and smoking (hazard ratio 1.41; 95% confidence interval 1.09–1.83 [p = .010]).
It has been shown that biomechanical ABR is a strong independent predictor of AAA rupture or repair in a model incorporating known risk factors, including diameter. Determining ABR at baseline could help guide the management of patients with AAA.
[Display omitted] |
| doi_str_mv | 10.1016/j.ejvs.2020.02.023 |
| format | Article |
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In a prospective multicentre clinical study of 295 patients with an abdominal aortic aneurysm (AAA; diameter ≥ 40 mm), three dimensional reconstruction and computational biomechanical analyses were used to compute ABR at baseline. Participants were followed for at least two years and the primary end point was the composite of aneurysm rupture or repair.
The majority were male (87%), current or former smokers (86%), most (72%) had hypertension (mean ± standard deviation [SD] systolic blood pressure 140 ± 22 mmHg), and mean ± SD baseline diameter was 49.0 ± 6.9 mm. Mean ± SD ABR was 0.49 ± 0.27. Participants were followed up for a mean ± SD of 848 ± 379 days and rupture (n = 13) or repair (n = 102) occurred in 115 (39%) cases. The number of repairs increased across tertiles of ABR: low (n = 24), medium (n = 34), and high ABR (n = 44) (p = .010). Rupture or repair occurred more frequently in those with higher ABR (log rank p = .009) and ABR was independently predictive of this outcome after adjusting for diameter and other clinical risk factors, including sex and smoking (hazard ratio 1.41; 95% confidence interval 1.09–1.83 [p = .010]).
It has been shown that biomechanical ABR is a strong independent predictor of AAA rupture or repair in a model incorporating known risk factors, including diameter. Determining ABR at baseline could help guide the management of patients with AAA.
[Display omitted]</description><identifier>ISSN: 1078-5884</identifier><identifier>EISSN: 1532-2165</identifier><identifier>DOI: 10.1016/j.ejvs.2020.02.023</identifier><identifier>PMID: 32253165</identifier><language>eng</language><publisher>England: Elsevier B.V</publisher><subject>Abdominal aortic aneurysm ; Aged ; Aged, 80 and over ; Aorta, Abdominal - diagnostic imaging ; Aorta, Abdominal - physiopathology ; Aorta, Abdominal - surgery ; Aortic Aneurysm, Abdominal - complications ; Aortic Aneurysm, Abdominal - diagnostic imaging ; Aortic Aneurysm, Abdominal - physiopathology ; Aortic Aneurysm, Abdominal - surgery ; Aortic Rupture - diagnostic imaging ; Aortic Rupture - etiology ; Aortic Rupture - physiopathology ; Aortic Rupture - surgery ; Aortography ; Biomechanical Phenomena ; Computational biomechanics ; Computed Tomography Angiography ; Disease Progression ; Female ; Hemodynamics ; Humans ; Imaging ; Magnetic Resonance Angiography ; Male ; Models, Cardiovascular ; Patient-Specific Modeling ; Peripheral vascular disease ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Assessment ; Risk Factors ; Stress, Mechanical ; Time Factors ; Vascular Surgical Procedures</subject><ispartof>European journal of vascular and endovascular surgery, 2020-09, Vol.60 (3), p.365-373</ispartof><rights>2020 European Society for Vascular Surgery</rights><rights>Copyright © 2020 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-1b0f63d0d44563752ba19beb35f1e4179b6f8a0ee7ebb9e217a9e029400771293</citedby><cites>FETCH-LOGICAL-c400t-1b0f63d0d44563752ba19beb35f1e4179b6f8a0ee7ebb9e217a9e029400771293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejvs.2020.02.023$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32253165$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Doyle, Barry J.</creatorcontrib><creatorcontrib>Bappoo, Nikhilesh</creatorcontrib><creatorcontrib>Syed, Maaz B.J.</creatorcontrib><creatorcontrib>Forsythe, Rachael O.</creatorcontrib><creatorcontrib>Powell, Janet T.</creatorcontrib><creatorcontrib>Conlisk, Noel</creatorcontrib><creatorcontrib>Hoskins, Peter R.</creatorcontrib><creatorcontrib>McBride, Olivia M.B.</creatorcontrib><creatorcontrib>Shah, Anoop S.V.</creatorcontrib><creatorcontrib>Norman, Paul E.</creatorcontrib><creatorcontrib>Newby, David E.</creatorcontrib><title>Biomechanical Assessment Predicts Aneurysm Related Events in Patients with Abdominal Aortic Aneurysm</title><title>European journal of vascular and endovascular surgery</title><addtitle>Eur J Vasc Endovasc Surg</addtitle><description>To test whether aneurysm biomechanical ratio (ABR; a dimensionless ratio of wall stress and wall strength) can predict aneurysm related events.
In a prospective multicentre clinical study of 295 patients with an abdominal aortic aneurysm (AAA; diameter ≥ 40 mm), three dimensional reconstruction and computational biomechanical analyses were used to compute ABR at baseline. Participants were followed for at least two years and the primary end point was the composite of aneurysm rupture or repair.
The majority were male (87%), current or former smokers (86%), most (72%) had hypertension (mean ± standard deviation [SD] systolic blood pressure 140 ± 22 mmHg), and mean ± SD baseline diameter was 49.0 ± 6.9 mm. Mean ± SD ABR was 0.49 ± 0.27. Participants were followed up for a mean ± SD of 848 ± 379 days and rupture (n = 13) or repair (n = 102) occurred in 115 (39%) cases. The number of repairs increased across tertiles of ABR: low (n = 24), medium (n = 34), and high ABR (n = 44) (p = .010). Rupture or repair occurred more frequently in those with higher ABR (log rank p = .009) and ABR was independently predictive of this outcome after adjusting for diameter and other clinical risk factors, including sex and smoking (hazard ratio 1.41; 95% confidence interval 1.09–1.83 [p = .010]).
It has been shown that biomechanical ABR is a strong independent predictor of AAA rupture or repair in a model incorporating known risk factors, including diameter. Determining ABR at baseline could help guide the management of patients with AAA.
[Display omitted]</description><subject>Abdominal aortic aneurysm</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aorta, Abdominal - diagnostic imaging</subject><subject>Aorta, Abdominal - physiopathology</subject><subject>Aorta, Abdominal - surgery</subject><subject>Aortic Aneurysm, Abdominal - complications</subject><subject>Aortic Aneurysm, Abdominal - diagnostic imaging</subject><subject>Aortic Aneurysm, Abdominal - physiopathology</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Aortic Rupture - diagnostic imaging</subject><subject>Aortic Rupture - etiology</subject><subject>Aortic Rupture - physiopathology</subject><subject>Aortic Rupture - surgery</subject><subject>Aortography</subject><subject>Biomechanical Phenomena</subject><subject>Computational biomechanics</subject><subject>Computed Tomography Angiography</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Imaging</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Models, Cardiovascular</subject><subject>Patient-Specific Modeling</subject><subject>Peripheral vascular disease</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stress, Mechanical</subject><subject>Time Factors</subject><subject>Vascular Surgical Procedures</subject><issn>1078-5884</issn><issn>1532-2165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LJDEQhoO4rF_7BzxIH_fSYyXpdLrBy6zoKggry3oOSboaM_SHpjIj_nszO-pRKEhBnveFehg75bDgwOvz1QJXG1oIELAAkUfusUOupCgFr9V-3kE3pWqa6oAdEa0AQHGpvrMDKYSSmTlk3a8wj-gf7RS8HYolERKNOKXiPmIXfKJiOeE6vtJY_MXBJuyKq03-pyJMxb1N4f_-EtJjsXTdPIZpWzPHFPxn8oR96-1A-OP9PWYP11f_Lm_Kuz-_by-Xd6WvAFLJHfS17KCrKlVLrYSzvHXopOo5Vly3ru4bC4ganWtRcG1bBNHmsNZctPKY_dz1PsX5eY2UzBjI4zDYCec1GSEbLVSt6yajYof6OBNF7M1TDKONr4aD2do1K7O1a7Z2DYg8MofO3vvXbsTuM_KhMwMXOwDzlZuA0ZDPgnw2GdEn083hq_433lGL6g</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Doyle, Barry J.</creator><creator>Bappoo, Nikhilesh</creator><creator>Syed, Maaz B.J.</creator><creator>Forsythe, Rachael O.</creator><creator>Powell, Janet T.</creator><creator>Conlisk, Noel</creator><creator>Hoskins, Peter R.</creator><creator>McBride, Olivia M.B.</creator><creator>Shah, Anoop S.V.</creator><creator>Norman, Paul E.</creator><creator>Newby, David E.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202009</creationdate><title>Biomechanical Assessment Predicts Aneurysm Related Events in Patients with Abdominal Aortic Aneurysm</title><author>Doyle, Barry J. ; Bappoo, Nikhilesh ; Syed, Maaz B.J. ; Forsythe, Rachael O. ; Powell, Janet T. ; Conlisk, Noel ; Hoskins, Peter R. ; McBride, Olivia M.B. ; Shah, Anoop S.V. ; Norman, Paul E. ; Newby, David E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-1b0f63d0d44563752ba19beb35f1e4179b6f8a0ee7ebb9e217a9e029400771293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal aortic aneurysm</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aorta, Abdominal - diagnostic imaging</topic><topic>Aorta, Abdominal - physiopathology</topic><topic>Aorta, Abdominal - surgery</topic><topic>Aortic Aneurysm, Abdominal - complications</topic><topic>Aortic Aneurysm, Abdominal - diagnostic imaging</topic><topic>Aortic Aneurysm, Abdominal - physiopathology</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Aortic Rupture - diagnostic imaging</topic><topic>Aortic Rupture - etiology</topic><topic>Aortic Rupture - physiopathology</topic><topic>Aortic Rupture - surgery</topic><topic>Aortography</topic><topic>Biomechanical Phenomena</topic><topic>Computational biomechanics</topic><topic>Computed Tomography Angiography</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Imaging</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Models, Cardiovascular</topic><topic>Patient-Specific Modeling</topic><topic>Peripheral vascular disease</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stress, Mechanical</topic><topic>Time Factors</topic><topic>Vascular Surgical Procedures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Doyle, Barry J.</creatorcontrib><creatorcontrib>Bappoo, Nikhilesh</creatorcontrib><creatorcontrib>Syed, Maaz B.J.</creatorcontrib><creatorcontrib>Forsythe, Rachael O.</creatorcontrib><creatorcontrib>Powell, Janet T.</creatorcontrib><creatorcontrib>Conlisk, Noel</creatorcontrib><creatorcontrib>Hoskins, Peter R.</creatorcontrib><creatorcontrib>McBride, Olivia M.B.</creatorcontrib><creatorcontrib>Shah, Anoop S.V.</creatorcontrib><creatorcontrib>Norman, Paul E.</creatorcontrib><creatorcontrib>Newby, David E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of vascular and endovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Doyle, Barry J.</au><au>Bappoo, Nikhilesh</au><au>Syed, Maaz B.J.</au><au>Forsythe, Rachael O.</au><au>Powell, Janet T.</au><au>Conlisk, Noel</au><au>Hoskins, Peter R.</au><au>McBride, Olivia M.B.</au><au>Shah, Anoop S.V.</au><au>Norman, Paul E.</au><au>Newby, David E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Biomechanical Assessment Predicts Aneurysm Related Events in Patients with Abdominal Aortic Aneurysm</atitle><jtitle>European journal of vascular and endovascular surgery</jtitle><addtitle>Eur J Vasc Endovasc Surg</addtitle><date>2020-09</date><risdate>2020</risdate><volume>60</volume><issue>3</issue><spage>365</spage><epage>373</epage><pages>365-373</pages><issn>1078-5884</issn><eissn>1532-2165</eissn><abstract>To test whether aneurysm biomechanical ratio (ABR; a dimensionless ratio of wall stress and wall strength) can predict aneurysm related events.
In a prospective multicentre clinical study of 295 patients with an abdominal aortic aneurysm (AAA; diameter ≥ 40 mm), three dimensional reconstruction and computational biomechanical analyses were used to compute ABR at baseline. Participants were followed for at least two years and the primary end point was the composite of aneurysm rupture or repair.
The majority were male (87%), current or former smokers (86%), most (72%) had hypertension (mean ± standard deviation [SD] systolic blood pressure 140 ± 22 mmHg), and mean ± SD baseline diameter was 49.0 ± 6.9 mm. Mean ± SD ABR was 0.49 ± 0.27. Participants were followed up for a mean ± SD of 848 ± 379 days and rupture (n = 13) or repair (n = 102) occurred in 115 (39%) cases. The number of repairs increased across tertiles of ABR: low (n = 24), medium (n = 34), and high ABR (n = 44) (p = .010). Rupture or repair occurred more frequently in those with higher ABR (log rank p = .009) and ABR was independently predictive of this outcome after adjusting for diameter and other clinical risk factors, including sex and smoking (hazard ratio 1.41; 95% confidence interval 1.09–1.83 [p = .010]).
It has been shown that biomechanical ABR is a strong independent predictor of AAA rupture or repair in a model incorporating known risk factors, including diameter. Determining ABR at baseline could help guide the management of patients with AAA.
[Display omitted]</abstract><cop>England</cop><pub>Elsevier B.V</pub><pmid>32253165</pmid><doi>10.1016/j.ejvs.2020.02.023</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1078-5884 |
| ispartof | European journal of vascular and endovascular surgery, 2020-09, Vol.60 (3), p.365-373 |
| issn | 1078-5884 1532-2165 |
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| subjects | Abdominal aortic aneurysm Aged Aged, 80 and over Aorta, Abdominal - diagnostic imaging Aorta, Abdominal - physiopathology Aorta, Abdominal - surgery Aortic Aneurysm, Abdominal - complications Aortic Aneurysm, Abdominal - diagnostic imaging Aortic Aneurysm, Abdominal - physiopathology Aortic Aneurysm, Abdominal - surgery Aortic Rupture - diagnostic imaging Aortic Rupture - etiology Aortic Rupture - physiopathology Aortic Rupture - surgery Aortography Biomechanical Phenomena Computational biomechanics Computed Tomography Angiography Disease Progression Female Hemodynamics Humans Imaging Magnetic Resonance Angiography Male Models, Cardiovascular Patient-Specific Modeling Peripheral vascular disease Predictive Value of Tests Prognosis Prospective Studies Risk Assessment Risk Factors Stress, Mechanical Time Factors Vascular Surgical Procedures |
| title | Biomechanical Assessment Predicts Aneurysm Related Events in Patients with Abdominal Aortic Aneurysm |
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