Novel prognostic biometrics in computed tomography in patients with abdominal aortic aneurysm

Ruben Buijs concludes the first part of his thesis by stating that computed tomography (CT) analysis of abdominal aortic aneurysm (AAA) calcification might have a predictive value for the assessment of rupture risk. However, this is impeded by the lacking accuracy of available CT image analysis technology. The prognostics and diagnostics of AAA are currently based on the diameter of the aneurysm. In spite of this, the diameter is not fully predictive for AAA-rupture, given the fact that very large aneurysms do not always rupture and that small aneurysms can rupture still. For his research, Buijs studied alternative biometric characteristics and measurement methods. AAA calcification was a clinically applicable risk factor for AAA-rupture. Nonetheless, Buijs shows that the available automated calcification scoring methods can be highly inaccurate and variable, especially in the presence of contrast agents in the aorta. The second part of this thesis concentrates on the sizing of aortic prosthetics for the treatment of AAA. A common complication after endovascular aneurysm repair is the leakage of blood between the aneurysm wall and the endoprosthesis. This leakage might be prevented by more accurate sizing of the prosthesis. A mathematically more accurate sizing method was found, yet Buijs concludes that this method deserves further investigation in a greater clinical population. Additional alternatives for AAA calcification scoring and aortic prosthesis sizing ought to be studied and compared, to provide scientific basis for the increased reliance on these techniques