Understanding and Improving Risk Assessment of Abdominal Aortic Aneurysm Growth Using Statistical Shape Modeling of the Infrarenal Aorta

Maximum diameter of the aneurysmal sac remains the primary method for defining surveillance intervals and the timing for surgical intervention. Recent studies have attempted to expand on this one-dimensional metric by incorporating additional descriptors of the aneurysmal sac such as undulation, curvature and tortuosity. However, these metrics are often biased and may overlook certain anatomical abnormalities, limiting predictive potential. This study aimed to identify novel three-dimensional shape features of the aneurysmal flow lumen and outer wall structure (OWS, with or without intraluminal thrombus) to predict aneurysmal growth.