SAFE AORTA

• University of Western Macedonia
• Hellenic Mediterranean University
• University of Western Attica
• Technical University of Crete
• Biomedical Research Foundations Academy of Athens
• University of the Peloponnese

An Abdominal Aortic Aneurysm (AAA) is defined as a permanent localized dilatation that exceeds 50% of normal diameter (>3 cm). The main complication of AAAs is rupture which is the 13th most common cause of death and the 3rd most common cause of sudden death in the Western world, after acute myocardial infarction and stroke. AAAs are in most cases diagnosed during random routine checks, because they are usually asymptomatic. Factors that have been associated with the risk of AAA are smoking, age, family history, lipid levels, hypertension, and the presence of coronary, carotid, or peripheral vascular disease. Despite the clear epidemiological association with AAA, none of the specific factors can be considered as an independent cause or predictor of the occurrence of AAA. Despite the progress in Medicine, the mortality rates from AAA rupture in the last 50 years remain at very high levels reaching 80-90%.

For men over 65 years of age and for women in high-risk groups, systematic monitoring through imaging tests is recommended to detect possible AAA. Prophylactic surgery is recommended in patients with a risk of AAA rupture that exceeds the risk of intervention. The existing guidelines for the invasive treatment of an AAA are based on two criteria, 1) the maximum diameter with a critical value of 5.5 cm for men and 5.0 cm for women, and 2) the annual rate of diameter growth. The adoption of maximum diameter as an indicator of rupture risk was based in part on a retrospective review of 24,000 consecutive autopsies over 23 years at a single institution.

The main objective of the SAFE-AORTA research proposal is the development of a Clinical Decision Support System for the accurate prediction of morphological evolution and the probability of AAA rupture. More specifically, the goals of the project are:
Objective 1: Implementation of an individual electronic health record of aneurysmal patients and integration of medical data bases of the collaborating vascular surgery clinics.
Objective 2: Collect a large volume of retrospective and prospective data on the AAA disease
Objective 3: Development of the digital aortic twin of patients with AAA
Objective 4: Development of prediction models of the geometric evolution and risk of AAA rupture