{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:20:16Z","timestamp":1791289216225,"version":"4.3.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Information on the predictive determinants of abdominal aortic aneurysm rupture from CT angiography are scarce. The aim of this study was to investigate biomechanical parameters in abdominal aortic aneurysms and their association with risk of subsequent rupture.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective study, the digital radiological archive was searched for 363 patients with ruptured abdominal aortic aneurysms. All patients who underwent at least one CT angiography examination before aneurysm rupture were included. CT angiography results were analysed to determine maximum aneurysm diameter, aneurysm volume, and biomechanical parameters (peak wall stress and peak wall rupture index). In the primary survival analysis, patients with abdominal aortic aneurysms less than 70\u2005mm were considered. Sensitivity analyses including control patients and abdominal aortic aneurysms of all sizes were performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 67 patients who underwent 109 CT angiography examinations before aneurysm rupture were identified. The majority were men (47, 70%) and the median age at the time of CTA examination was 77 (71\u201383) years. The median maximum aneurysm diameter was 56 (interquartile range 46\u201365) mm and the median time to rupture was 2.13 (interquartile range 0.64\u20134.72) years. In univariable analysis, maximum aneurysm diameter, aneurysm volume, peak wall stress, and peak wall rupture index were all associated with risk of rupture. Women had an increased HR for rupture when adjusted for maximum aneurysm diameter or aneurysm volume (HR 2.16, 95% c.i. 1.23 to 3.78 (P = 0.007) and HR 1.92, 95% c.i. 1.06 to 3.50 (P = 0.033) respectively). In multivariable analysis, the peak wall rupture index was associated with risk of rupture. The HR for peak wall rupture index was 1.05 (95% c.i. 1.03 to 1.08) per % (P &amp;lt; 0.001) when adjusted for maximum aneurysm diameter and 1.05 (95% c.i. 1.02 to 1.08) per % (P &amp;lt; 0.001) when adjusted for aneurysm volume.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Biomechanical factors appear to be important in the prediction of abdominal aortic aneurysm rupture. Women are at increased risk of rupture when adjustments are made for maximum aneurysm diameter alone.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znae125","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T01:24:18Z","timestamp":1716513858000},"source":"Crossref","is-referenced-by-count":10,"title":["Peak wall rupture index is associated with risk of rupture of abdominal aortic aneurysms, independent of size and sex"],"prefix":"10.1093","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2551-2526","authenticated-orcid":false,"given":"Antti","family":"Siika","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institute , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mareia","family":"Talvitie","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institute , Stockholm , Sweden"},{"name":"Department of Vascular Surgery, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Lindquist Liljeqvist","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institute , Stockholm , Sweden"},{"name":"Department of Vascular Surgery, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Bogdanovic","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institute , Stockholm , Sweden"},{"name":"Department of Vascular Surgery, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T Christian","family":"Gasser","sequence":"additional","affiliation":[{"name":"KTH Solid Mechanics, Department of Engineering Mechanics, School of Engineering Sciences, KTH Royal Institute of Technology , Stockholm , Sweden"},{"name":"Faculty of Health Sciences, University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8869-0493","authenticated-orcid":false,"given":"Rebecka","family":"Hultgren","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institute , Stockholm , Sweden"},{"name":"Department of Vascular Surgery, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5645-1260","authenticated-orcid":false,"given":"Joy","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institute , Stockholm , Sweden"},{"name":"Department of Vascular Surgery, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,24]]},"reference":[{"key":"2024052401240701500_znae125-B1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ejvs.2018.09.020","article-title":"Editor\u2019s Choice\u2014European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms","volume":"57","author":"Wanhainen","year":"2019","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024052401240701500_znae125-B2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jvs.2017.10.044","article-title":"The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm","volume":"67","author":"Chaikof","year":"2018","journal-title":"J Vasc Surg"},{"key":"2024052401240701500_znae125-B3","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.jvs.2009.10.113","article-title":". 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