{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:20:55Z","timestamp":1793946055245,"version":"4.8.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,4,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Prior studies have suggested aortic peak wall stress (PWS) and peak wall rupture index (PWRI) can estimate the rupture risk of an abdominal aortic aneurysm (AAA), but whether these measurements have independent predictive ability over assessing AAA diameter alone is unclear. The aim of this systematic review was to compare PWS and PWRI in participants with ruptured and asymptomatic intact AAAs of similar diameter.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Web of Science, Scopus, Medline, and The Cochrane Library were systematically searched to identify studies assessing PWS and PWRI in ruptured and asymptomatic intact AAAs of similar diameter. Random\u2010effects meta\u2010analyses were performed using inverse variance\u2010weighted methods. Leave\u2010one\u2010out sensitivity analyses were conducted to assess the robustness of findings. Risk of bias was assessed using a modification of the Newcastle\u2010Ottawa scale and standard quality assessment criteria for evaluating primary research papers. Seven case\u2010control studies involving 309 participants were included. Meta\u2010analyses suggested that PWRI (standardized mean difference, 0.42; 95% CI, 0.14\u20130.70;\n              <jats:italic>P<\/jats:italic>\n              =0.004) but not PWS (standardized mean difference, 0.13; 95% CI, \u22120.18 to 0.44;\n              <jats:italic>P<\/jats:italic>\n              =0.418) was greater in ruptured than intact AAAs. Sensitivity analyses suggested that the findings were not dependent on the inclusion of any single study. The included studies were assessed to have a medium to high risk of bias.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Based on limited evidence, this study suggested that PWRI, but not PWS, is greater in ruptured than asymptomatic intact AAAs of similar maximum aortic diameter.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019772","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T10:27:32Z","timestamp":1618482452000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Systematic Review and Meta\u2010Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3843-4886","authenticated-orcid":false,"given":"Tejas P.","family":"Singh","sequence":"first","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University Townsville Queensland Australia"},{"name":"The Department of Vascular and Endovascular Surgery The Townsville University Hospital Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph V.","family":"Moxon","sequence":"additional","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University Townsville Queensland Australia"},{"name":"The Australian Institute of Tropical Health and MedicineJames Cook University Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Christian","family":"Gasser","sequence":"additional","affiliation":[{"name":"Department of Engineering Mechanics KTH Solid MechanicsKTH Royal Institute of Technology Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-8848","authenticated-orcid":false,"given":"Jonathan","family":"Golledge","sequence":"additional","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University Townsville Queensland Australia"},{"name":"The Department of Vascular and Endovascular Surgery The Townsville University Hospital Townsville Queensland Australia"},{"name":"The Australian Institute of Tropical Health and MedicineJames Cook University Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-018-0114-9"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2013.12.010"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9578"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)10137-X"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.09.020"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2010.08.026"},{"key":"e_1_3_1_8_2","article-title":"Comparison of peak wall stress and peak wall rupture index in ruptured and asymptomatic intact abdominal aortic aneurysms (accepted)","author":"Singh TPMJ","year":"2020","unstructured":"Singh TPMJ, Iyer V, Gasser T, Jenkins J, Golledge J. 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