Biomechanics of AAA surveillance patients

Abstract: Abdominal aortic aneurysms (AAA) occurs due to local enlargement of the abdominal aorta and affects about 1-2 % of the elderly Swedish population. At admission, AAA patients receive a Computed Tomography-Angiography (CT-A) scanning, and later they are followed-up by 2D ultrasound examinations. There is a need to know if an adequate geometry can be constructed from the baseline CT-A scan and follow-up 2D ultrasounds. To test our hypothesis only CT-A images have been used from six patients and hypothetical ultrasound cross-sections (HUCS) were extracted from the follow-up CT-A scans. The baseline AAA surface was expanded in a mechanical model by applying pressure inside of it until it reached the HUCS. The obtained morphed geometries were then compared with the CT-A-based geometries. The discrepancy between them were calculated by distance measurements. Also, the rupture risk indicators volumes and stresses were compared. Finally, a sensitivity analysis studied the effect of HUCS positioning on the volumes and stresses. The results show that an adequate geometry can be constructed by the investigated concept of morphing. The average distances between the morphed and CT-A-based geometries are 2-4 mm. The average volume difference for the six patients are between 3.8-16.2 %. The wall stress for the morphed and CT-A-based geometries are close only for the first follow-up.