Intervention for heart protection
Dr Tejas Singh is on a quest to prevent thousands of deaths world-wide by investigating techniques to better predict the rupture risk of abdominal aortic aneurysms.
Recently a Junior Doctor at the Townsville University Hospital, Dr Singh has taken up a research fellowship with JCU's Queensland Research Centre for Peripheral Vascular Disease (QRCPVD). Dr Singh explains how a technique used by engineers could be the key to early intervention.
Have you ever inflated a balloon with so much air causing it to suddenly burst? What if I told you that something similar could happen to the blood vessels in our body?
What is an AAA?
Abdominal aortic aneurysm, also known as an AAA, is a balloon like enlargement of the main blood vessel that supplies blood and nutrients to the vital organs in our body. As an AAA grows larger in its size, the risk of it suddenly rupturing increases, resulting in life threatening bleeding within the abdomen — often without warning. AAA rupture is responsible for approximately 200,000 deaths world-wide per year.
The only treatment we have for this condition is surgical repair. However, 75 per cent of patients who undergo an emergency operation for a ruptured AAA do not survive. The risk of an AAA rupture is currently assessed by measuring the diameter of the enlarged portion of the blood vessel. As the AAA grows larger in size or its diameter, so does the likelihood of it rupturing. Therefore, this measurement is currently used by clinicians to guide them in deciding which AAAs require surgical repair.
Unfortunately, some small AAAs do rupture before reaching the current threshold for repair, while some large AAAs remain stable throughout a patient's lifetime. This suggests that measuring diameter alone is not a perfect tool in deciding which AAAs will require surgical intervention.
Engineering an intervention
My research is investigating whether an engineering technique called ‘Finite Element Analysis’ can be used to predict the risk of AAA rupture. This method was developed to help engineers find weak spots or areas of high wall stress in their three dimensional designs. Applying this technology to the CT scans of AAA patients may potentially help us identify which cases are more likely to rupture.
In our preliminary findings, we found that individuals with a high wall stress were more likely to have a ruptured AAA independent of the diameter. We will now apply this technique to a much larger group of patients, to investigate whether individuals with higher wall stress have faster growing AAAs and an increased risk of rupture during follow up.
It is hoped that this measure may help us more effectively identify individuals who will benefit from AAA surgery and improve the outcomes for our patients.
Featured researcher
Dr Tejas Singh
Research Fellow
Dr Tejas P Singh is a Junior Doctor at the Townsville University Hospital and a Research Fellow with the Queensland Research Centre for Peripheral Vascular Disease (QRCPVD) at JCU’s College of Medicine and Dentistry. After graduating from a Bachelor of Medicine, Bachelor of Surgery, Dr Singh completed a Masters of Public Health and a Doctor of Philosophy at JCU.
Dr Singh aspires to provide quality clinical care to patients with vascular diseases and contribute research aimed at improving the management of peripheral vascular diseases. His PhD research focused on finding ways that abdominal aortic aneurysm risk can be identified earlier in patients, to greater improve positive outcomes for surgery.