{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:08:12Z","timestamp":1790701692280,"version":"4.1.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,11,21]],"date-time":"2016-11-21T00:00:00Z","timestamp":1479686400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:p>Purpose: To review the use of biomechanical indices for the estimation of abdominal aortic aneurysm (AAA) rupture risk, emphasizing their potential use in a clinical setting. Methods: A search of the PubMed, Embase, Scopus, and Compendex databases was made up to June 2015 to identify articles involving biomechanical analysis of AAA rupture risk. Outcome variables [aneurysm diameter, peak wall stress (PWS), peak wall shear stress (PWSS), wall strain, peak wall rupture index (PWRI), and wall stiffness] were compared for asymptomatic intact AAAs vs symptomatic or ruptured AAAs. For quantitative analysis of the pooled data, a random effects model was used to calculate the standard mean differences (SMDs) with the 95% confidence interval (CI) for the biomechanical indices. Results: The initial database searches yielded 1894 independent articles of which 19 were included in the analysis. The PWS was significantly higher in the symptomatic\/ruptured group, with a SMD of 1.11 (95% CI 0.93 to 1.26, p&lt;0.001). Likewise, the PWRI was significantly higher in the ruptured or symptomatic group, with a SMD of 1.15 (95% CI 0.30 to 2.01, p=0.008). After adjustment for the aneurysm diameter, the PWS remained higher in the ruptured or symptomatic group, with a SMD of 0.85 (95% CI 0.46 to 1.23, p&lt;0.001). Less is known of the wall shear stress and wall strain indices, as too few studies were available for analysis. Conclusion: Biomechanical indices are a promising tool in the assessment of AAA rupture risk as they incorporate several factors, including geometry, tissue properties, and patient-specific risk factors. However, clinical implementation of biomechanical AAA assessment remains a challenge owing to a lack of standardization.<\/jats:p>","DOI":"10.1177\/1526602816680088","type":"journal-article","created":{"date-parts":[[2016,11,21]],"date-time":"2016-11-21T21:05:13Z","timestamp":1479762313000},"page":"254-261","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":41,"title":["Biomechanical Indices for Rupture Risk Estimation in Abdominal Aortic Aneurysms"],"prefix":"10.1177","volume":"24","author":[{"given":"Eva L.","family":"Leemans","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, the Netherlands"},{"name":"Department of Biomechanical Engineering and Physics, Academic Medical Centre, Amsterdam, the Netherlands"},{"name":"Department of Radiology, Academic Medical Centre, Amsterdam, the Netherlands"},{"name":"MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Enschede, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tineke P.","family":"Willems","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Center Groningen, University of Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten J.","family":"van der Laan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis H.","family":"Slump","sequence":"additional","affiliation":[{"name":"MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Enschede, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clark J.","family":"Zeebregts","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,11,21]]},"reference":[{"key":"bibr1-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2010.09.011"},{"key":"bibr2-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318282ab8f"},{"key":"bibr3-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16979-1"},{"key":"bibr4-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(98)70207-1"},{"key":"bibr5-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5778"},{"key":"bibr6-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1177\/1708538114532084"},{"key":"bibr7-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-821X(05)80718-2"},{"key":"bibr8-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2003.40"},{"key":"bibr9-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-007-0833-5"},{"key":"bibr10-1526602816680088","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2010.02.007"},{"key":"bibr11-1526602816680088","unstructured":"Wells GA, Shea B, O\u2019Connell D, The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Ottawa Hospital\/Research Institute web site]. http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. 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