Results of a study by researchers at Dartmouth-Hitchcock Medical Center (DHMC) and Dartmouth Thayer School of Engineering could have implications for choosing which patients with abdominal aortic aneurysms should have surgery and which ones should simply have follow-up with noninvasive studies.
In an article published in the April issue of the Journal of Vascular Surgery, Dr. Mark Fillinger and colleagues describe a new noninvasive method for evaluating abdominal aortic aneurysms (AAA). They found that the new method – examining aneurysm wall stress – predicts AAA rupture risk better than aneurysm diameter, which has been used to predict rupture risk for over 40 years.
The multidisciplinary study was sponsored by the National Institutes of Health and the National Heart Lung and Blood Institute. In the study, conducted at Dartmouth-Hitchcock Medical Center, over 100 patients who had computed tomography scans (CT scans) during the course of routine care had AAA “wall stress analysis”. The CT scan is processed through a series of computer programs, including an engineering process called finite element analysis. Finite element analysis breaks the structure into thousands of tiny elements so a computer can calculate the wall stress using the three-dimensional shape of the AAA (from the CT scan), the patient’s blood pressure, and the tissue properties of typical AAAs. The result is a computer-generated “stress map” that displays the aneurysm wall stress (the force trying to pull the aneurysm apart and cause rupture).
Tamsin Stubbs | DHMC
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