Competition of interest: ELC has been paid a consulting fee by and received clinical research funding from Guidant. MFF has received a speaking fee from Medtronic. JSM has been paid a consulting fee by and has received clinical research funding from Guidant, Medtronic, and WL Gore. He has also received research support from Boston Scientific. VMB is a consultant to and owns stock in Guidant. JM has been paid a consulting fee by Medtronic. CZ has been paid a consulting fee by and owns shares in Medtronic.

For AAAs under observation, peak AAA wall stress seems superior to diameter in differentiating patients who will experience catastrophic outcome. Elevated wall stress associated with rupture is not simply an acute event near the time of rupture.

No abstract

Peak wall stresses calculated in vivo for AAAs near the time of rupture were significantly higher than peak stresses for electively repaired AAAs, even when matched for maximal diameter. Calculation of wall stress with computer modeling of three-dimensional AAA geometry appears to assess rupture risk more accurately than AAA diameter or other previously proposed clinical indices. Stress analysis is practical and feasible and may become an important clinical tool for evaluation of AAA rupture risk.

No abstract