The long-term relationship of wall stress to the natural history of abdominal aortic aneurysms (finite element analysis and other methods)

For the past four decades, abdominal aortic aneurysm (AAA) rupture risk has been estimated using maximum aneurysm diameter. Although this works relatively well in general, clinicians know that some aneurysms rupture at an unusually small size, while others grow to exceptionally large sizes without rupture. We have demonstrated that finite element analysis (FEA) of AAA wall stress using three-dimensional computed tomography (CT) reconstructions is better than diameter for differentiating AAAs near the time of rupture, and that wall stress is superior to AAA diameter for predicting rupture risk in patients under observation. This article summarizes our current work, future areas of investigation, and issues related to "translational" research for FEA of aortic aneurysms.