Integrated Assessment of Wall Shear Stress-Related Hemodynamic Parameters in Abdominal Aortic Aneurysms: A Retrospective Cross-Sectional Study on Ruptured Cases.

Low TAWSS regions were associated with AAA rupture sites within a specific value range.

• TAWSS values in the range of 0–0.5 Pa were identified as high-risk locations for rupture.
• 22 AAA cases that had progressed to surgical intervention were assessed using CFD.
• CFD geometries were developed exclusively using patient computed tomography images.
• Simulations were run with general physiological boundary conditions.

High OSI regions were associated with AAA rupture sites within a specific value range.

• OSI values in the range of 0.35–0.5 were identified as high-risk locations for rupture.
• OSI (oscillatory shear index) is one of four key WSS-related hemodynamic parameters calculated for each case.
• The study included 22 AAA cases requiring surgical intervention.
• Spatial distribution analysis of OSI was used to assess rupture site prediction.

High ECAP regions were associated with AAA rupture sites within a specific value range.

• ECAP (endothelial cell activation potential) values in the range of 1.6–2.0 Pa⁻¹ were identified as high-risk locations for rupture.
• ECAP is one of four key WSS-related hemodynamic parameters evaluated in this study.
• 22 surgical AAA cases were analyzed using patient-specific CFD models.
• A clinically practical, low-input CFD pipeline was employed using only CT images and general physiological boundary conditions.

High RRT regions were associated with AAA rupture sites within a specific value range.

• RRT (relative residence time) values in the range of 24–30 were identified as high-risk locations for rupture.
• RRT is one of four key WSS-related hemodynamic parameters computed for each case.
• The analysis was performed on 22 AAA cases that required surgical intervention.
• Spatial distribution of RRT was examined in relation to known rupture sites.

Simultaneous analysis of all four hemodynamic parameters was found to be critical for rupture risk assessment.

• The four parameters assessed were TAWSS, OSI, ECAP, and RRT.
• Relying on any single parameter was considered insufficient; integrated assessment was emphasized.
• This finding parallels the clinical limitation of using only AAA diameter and growth rate as rupture risk indicators.
• The study notes that numerous cases have been reported where relying solely on diameter and growth rate has proven insufficient.

A clinically practical, low-input CFD pipeline using only patient CT images and general physiological boundary conditions was demonstrated for AAA hemodynamic assessment.

• CFD geometries were developed exclusively using patient computed tomography images.
• Simulations were run with general physiological boundary conditions rather than patient-specific flow measurements.
• 22 AAA cases requiring surgical intervention were included in this retrospective cross-sectional study.
• The approach was described as a 'clinically practical, low-input CFD pipeline.'

Standard clinical AAA rupture risk indicators (diameter and growth rate) have been reported as insufficient in numerous cases, motivating investigation of biomechanical factors.

• AAA diameter and growth rate are the parameters used in general practice as rupture risk indicators.
• Numerous cases have been reported where relying solely on these two AAA characteristics has proven insufficient.
• The study proposes that other biomechanical factors, specifically disturbed hemodynamics, deserve further consideration.
• The paper aims to investigate the involvement of disturbed hemodynamics in AAA rupture.