Abstract
We present a data-informed, highly personalized, probabilistic approach for the quantification of abdominal aortic aneurysm (AAA) rupture risk. Our novel framework builds upon a comprehensive database of tensile test results that were carried out on 305 AAA tissue samples from 139 patients, as well as corresponding non-invasively and clinically accessible patient-specific data. Based on this, a multivariate regression model is created to obtain a probabilistic description of personalized vessel wall properties associated with a prospective AAA patient. We formulate a probabilistic rupture risk index that consistently incorporates the available statistical information and generalizes existing approaches. For the efficient evaluation of this index, a flexible Kriging-based surrogate model with an active training process is proposed. In a case-control study, the methodology is applied on a total of 36 retrospective, diameter matched asymptomatic (group 1, n = 18) and known symptomatic/ruptured (group 2, n = 18) cohort of AAA patients. Finally, we show its efficacy to discriminate between the two groups and demonstrate competitive performance in comparison to existing deterministic and probabilistic biomechanical indices.
Highlights
An abdominal aortic aneurysm (AAA) is a slowly progressing vascular disease, causing an enlargement of the infrarenal aorta and is considered pathological if the aortic diameter exceeds 30 mm [1]
Based on our retrospective AAA database of non-invasive and invasive data pairs and a multioutput Gaussian process model fitted to this dataset
The computational procedure is summarized in Algorithm 1
Summary
An abdominal aortic aneurysm (AAA) is a slowly progressing vascular disease, causing an enlargement of the infrarenal aorta and is considered pathological if the aortic diameter exceeds 30 mm [1]. AAA prevalence has been reported within a range of 1.2% to 3.3% in men older than 60 years based on several studies in western societies [2]. AAAs develop asymptomatically over several years, but they can rapidly turn into a serious clinical emergency in case of rupture. More than 50% of patients with a ruptured AAA die before reaching the hospital [1] and perioperative mortality rates range from 40% to 60% [3].
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