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Towards patient-specific risk assessment of abdominal aortic aneurysm

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Abstract

Diagnosis of vascular disease and selection and planning of therapy are to a large extent based on the geometry of the diseased vessel. Treatment of a particular vascular disease is usually considered if the geometrical parameter that characterizes the severity of the disease, e.g. % vessel narrowing, exceeds a threshold. The thresholds that are used in clinical practice are based on epidemiological knowledge, which has been obtained by clinical studies including large numbers of patients. They may apply “on average”, but they can be sub-optimal for individual patients. To realize more patient-specific treatment decision criteria, more detailed knowledge may be required about the vascular hemodynamics, i.e. the blood flow and pressure in the diseased vessel and the biomechanical reaction of the vessel wall to this flow and pressure. Over the last decade, a substantial number of publications have appeared on hemodynamic modeling. Some studies have provided first evidence that this modeling may indeed be used to support therapeutic decisions. The goal of the research reported in this paper is to go one step further, namely to investigate the feasibility of a patient-specific hemodynamic modeling methodology that is not only effective (improves therapeutic decisions), but that is also efficient (easy to use, fast, as much as possible automatic) and robust (insensitive to variation in the quality of the input data, same outcome for different users). A review is presented of our research performed during the last 5 years and the results that were achieved. This research focused on the risk assessment for one particular disease, namely abdominal aortic aneurysm, a life-threatening dilatation of the abdominal aorta.

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Acknowledgments

This research was performed in the scope of the Hemodyn project, a cooperation between Philips Healthcare Best (Healthcare Informatics), the Technische Universiteit Eindhoven (Biomedical Engineering department) and the Erasmus University (Thoraxcenter, Biomedical Engineering), Rotterdam, The Netherlands. The Hemodyn project was partly funded by SenterNovem (Dutch Ministry of Economic Affairs). We are grateful to Mustafa Megahed and the CFD Team of the ESI group for the support on interfacing to and using the CFD-ACE+ software.

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Authors and Affiliations

  1. Philips Healthcare, Healthcare Informatics, Building QV 162, P.O. Box 10.000, 5680 DA, Best, The Netherlands

    M. Breeuwer, U. Kose, K. Visser & F. Gerritsen

  2. Faculty of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 512, 5600 MB, Eindhoven, The Netherlands

    S. de Putter, L. Speelman, F. Gerritsen, T. Gunther, B. Wolters, E. van Dam & F. van de Vosse

  3. Philips Healthcare, Magnetic Resonance Imaging, P.O. Box 10.000, 5680 DA, Best, The Netherlands

    R. Hoogeveen

  4. Department of Bioengineering, Imperial College London, South Kensington Campus, London, SW7 2A2, UK

    R. Krams

  5. Department of Radiology, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands

    H. van den Bosch

  6. Department of Vascular Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands

    J. Buth

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  1. M. Breeuwer
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  3. U. Kose
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  11. T. Gunther
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  13. E. van Dam
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Correspondence to M. Breeuwer.

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Breeuwer, M., de Putter, S., Kose, U. et al. Towards patient-specific risk assessment of abdominal aortic aneurysm. Med Biol Eng Comput 46, 1085–1095 (2008). https://doi.org/10.1007/s11517-008-0393-0

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