Local Morphologic and Hemodynamic Analyses for the Prediction of Abdominal Aortic Aneurysm Rupture Based on Patient-Specific CTA and Computational Modeling

Extensive research has focused on the evaluation of rupture risks in abdominal aortic aneurysms (AAAs) through comprehensive morphologic and hemodynamic analyses, primarily considering the AAA as a whole entity. This study tried to identify the high-risk rupture sites of AAAs more precisely before the fatal process based on morphologic and hemodynamic analyses at the local segment. Computed tomography angiography of a specific AAA patient was conducted at the follow-up 4 months before rupture, 1 day before rupture, the day of the rupture, and 15 days after endovascular aortic repair. The evolution of local morphology and the hemodynamic characteristics at these critical timepoints were investigated based on patient-specific reconstructions and computational fluid dynamics. The morphologic and hemodynamic parameters of the rupture region vary continuously in the process of AAA development and rupture. The surface area and volume of the rupture segment were gradually enlarged at the follow-up 4 months before rupture (47.33 cm ; 67.35 mL), 1 day before rupture (57.23 cm ; 85.24 mL), and on the day of the rupture (62.41cm ; 104.73ml). A prominent decrease in time-averaged wall shear stress and velocity for the rupture segment is observed. The percentages of the lowest time-averaged wall shear stress (