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Prediction of rupture risk in abdominal aortic aneurysm during observation: Wall stress versus diameter  Mark F. Fillinger, MDa, Steven P. Marra, PhDa,b,

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Presentation on theme: "Prediction of rupture risk in abdominal aortic aneurysm during observation: Wall stress versus diameter  Mark F. Fillinger, MDa, Steven P. Marra, PhDa,b,"— Presentation transcript:

1 Prediction of rupture risk in abdominal aortic aneurysm during observation: Wall stress versus diameter  Mark F. Fillinger, MDa, Steven P. Marra, PhDa,b, M.L. Raghavan, PhDa,b,c, Francis E. Kennedy, PhDb  Journal of Vascular Surgery  Volume 37, Issue 4, Pages (April 2003) DOI: /mva Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

2 Fig. 1 Three-dimensional stress distribution for maximum wall stress at peak systolic blood pressure for two 5.5 cm aneurysms. Stress is mapped to corresponding color, with highest stress shown in red and lowest stress shown in blue. Stress map for patient on the right has been color-coded to correspond with stress map for patient on the left, for ease of comparison. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

3 Fig. 2 A, Box plot. Rectangles, 25th to 75th percentile of data; horizontal bar within rectangles, median of data; short horizontal bars outside rectangles, 10th and 90th percentiles of the data; solid circles, any value below the 10th or above the 90th percentile. B, Box plot for AAA diameter demonstrates that 90% of AAAs under observation have diameter larger than the lowest recorded diameter for an AAA that subsequently ruptured or became symptomatic, which was 4.4 cm in maximum diameter. C, Box plot for peak AAA wall stress demonstrates that 75% of AAAs under observation have stress lower than the lowest recorded stress for an AAA that subsequently ruptured or became symptomatic. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

4 Fig. 3 Comparison of receiver operating characteristic curves shows superior sensitivity and specificity of peak wall stress in comparison with diameter throughout the clinically important range. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

5 Fig. 4 Life tables for freedom from rupture or emergency surgery because of acute symptoms. Top, Larger diameter was a highly significant predictor for rate of rupture, as shown for aneurysms larger than 5.5 cm. Middle, High stress was also a highly significant predictor for the rate of rupture. Bottom, Subgroups were analyzed for combinations of small and large diameter and low and high wall stress, with the same thresholds as used in the other life tables. Low-stress aneurysms had a low rupture rate whether they were small or large, and high-stress aneurysms had a high rupture rate regardless of size. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

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