Meta-analysis of peak wall stress in ruptured, symptomatic and intact abdominal aortic aneurysms

Khosla, S., Morris, D. R., Moxon, J. V., Walker, P. J., Gasser, T. C. and Golledge, J. (2014) Meta-analysis of peak wall stress in ruptured, symptomatic and intact abdominal aortic aneurysms. British Journal of Surgery, 101 11: 1350-1357. doi:10.1002/bjs.9578

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Author Khosla, S.
Morris, D. R.
Moxon, J. V.
Walker, P. J.
Gasser, T. C.
Golledge, J.
Title Meta-analysis of peak wall stress in ruptured, symptomatic and intact abdominal aortic aneurysms
Journal name British Journal of Surgery   Check publisher's open access policy
ISSN 0007-1323
1365-2168
Publication date 2014-10
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1002/bjs.9578
Open Access Status
Volume 101
Issue 11
Start page 1350
End page 1357
Total pages 8
Place of publication Chichester, West Sussex, England
Publisher John Wiley and Sons
Collection year 2015
Language eng
Formatted abstract
Background
Abdominal aortic aneurysm (AAA) is an important cause of sudden death; however, there are currently incomplete means to predict the risk of AAA rupture. AAA peak wall stress (PWS) can be estimated using finite element analysis (FEA) methods from computed tomography (CT) scans. The question is whether AAA PWS can predict AAA rupture. The aim of this systematic review was to compare PWS in patients with ruptured and intact AAA.

Methods
The MEDLINE database was searched on 25 May 2013. Case–control studies assessing PWS in asymptomatic intact, and acutely symptomatic or ruptured AAA from CT scans using FEA were included. Data were extracted independently. A random-effects model was used to calculate standard mean differences (SMDs) for PWS measurements.

Results
Nine studies assessing 348 individuals were identified and used in the meta-analysis. Results from 204 asymptomatic intact and 144 symptomatic or ruptured AAAs showed that PWS was significantly greater in the symptomatic/ ruptured AAAs compared with the asymptomatic intact AAAs (SMD 0·95, 95 per cent confidence interval 0·71 to 1·18; P < 0·001). The findings remained significant after adjustment for mean systolic blood pressure, standardized at 120 mmHg (SMD 0·68, 0·39 to 0·96; P < 0·001). Minimal heterogeneity between studies was noted (I2 = 0 per cent).

Conclusion
This study suggests that PWS is greater in symptomatic or ruptured AAA than in asymptomatic intact AAA.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: UQ Centre for Clinical Research Publications
Official 2015 Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
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