scholarly journals Quantitative Evaluation of Patient-Specific Conforming Hexahedral Meshes of Abdominal Aortic Aneurysms and Intraluminal Thrombus Generated from MRI

Author(s):  
J. Tarjuelo-Gutierrez ◽  
B. Rodriguez-Vila ◽  
D. M. Pierce ◽  
T. Fastl ◽  
E. J. Gomez
2013 ◽  
Vol 135 (2) ◽  
Author(s):  
J. S. Wilson ◽  
L. Virag ◽  
P. Di Achille ◽  
I. Karšaj ◽  
J. D. Humphrey

Most computational models of abdominal aortic aneurysms address either the hemodynamics within the lesion or the mechanics of the wall. More recently, however, some models have appropriately begun to account for the evolving mechanics of the wall in response to the changing hemodynamic loads. Collectively, this large body of work has provided tremendous insight into this life-threatening condition and has provided important guidance for current research. Nevertheless, there has yet to be a comprehensive model that addresses the mechanobiology, biochemistry, and biomechanics of thrombus-laden abdominal aortic aneurysms. That is, there is a pressing need to include effects of the hemodynamics on both the development of the nearly ubiquitous intraluminal thrombus and the evolving mechanics of the wall, which depends in part on biochemical effects of the adjacent thrombus. Indeed, there is increasing evidence that intraluminal thrombus in abdominal aortic aneurysms is biologically active and should not be treated as homogeneous inert material. In this review paper, we bring together diverse findings from the literature to encourage next generation models that account for the biochemomechanics of growth and remodeling in patient-specific, thrombus-laden abdominal aortic aneurysms.


2013 ◽  
Vol 52 (2) ◽  
pp. 159-168 ◽  
Author(s):  
J. Tarjuelo-Gutierrez ◽  
B. Rodriguez-Vila ◽  
D. M. Pierce ◽  
T. E. Fastl ◽  
P. Verbrugghe ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
B. Rodriguez-Vila ◽  
J. Tarjuelo-Gutierrez ◽  
P. Sánchez-González ◽  
P. Verbrugghe ◽  
I. Fourneau ◽  
...  

A correct patient-specific identification of the abdominal aortic aneurysm is useful for both diagnosis and treatment stages, as it locates the disease and represents its geometry. The actual thickness and shape of the arterial wall and the intraluminal thrombus are of great importance when predicting the rupture of the abdominal aortic aneurysms. The authors describe a novel method for delineating both the internal and external contours of the aortic wall, which allows distinguishing between vessel wall and intraluminal thrombus. The method is based on active shape model and texture statistical information. The method was validated with eight MR patient studies. There was high correspondence between automatic and manual measurements for the vessel wall area. Resulting segmented images presented a mean Dice coefficient with respect to manual segmentations of 0.88 and a mean modified Hausdorff distance of 1.14 mm for the internal face and 0.86 and 1.33 mm for the external face of the arterial wall. Preliminary results of the segmentation show high correspondence between automatic and manual measurements for the vessel wall and thrombus areas. However, since the dataset is small the conclusions cannot be generalized.


Author(s):  
Amirhossein Arzani ◽  
Shawn C. Shadden

Abdominal aortic aneurysms (AAA) are characterized by disturbed flow patterns, low and oscillatory wall shear stress with high gradients, increased particle residence time, and mild turbulence. Diameter is the most common metric for rupture prediction, although this metric can be unreliable. We hypothesize that understanding the flow topology and mixing inside AAA could provide useful insight into mechanisms of aneurysm growth. AAA morphology has high variability, as with AAA hemodynamics, and therefore we consider patient-specific analyses over several small to medium sized AAAs. Vortical patterns dominate AAA hemodynamics and traditional analyses based on the Eulerian fields (e.g. velocity) fail to convey the complex flow structures. The computation of finite-time Lyapunov exponent (FTLE) fields and underlying Lagrangian coherent structures (LCS) help reveal a Lagrangian template for quantifying the flow [1].


Author(s):  
David M. Pierce ◽  
Thomas E. Fastl ◽  
Hannah Weisbecker ◽  
Gerhard A. Holzapfel ◽  
Borja Rodriguez-Vila ◽  
...  

Through progress in medical imaging, image analysis and finite element (FE) meshing tools it is now possible to extract patient-specific geometries from medical images of, e.g., abdominal aortic aneurysms (AAAs), and thus to study clinically relevant problems via FE simulations. Medical imaging is most often performed in vivo, and hence the reconstructed model geometry in the problem of interest will represent the in vivo state, e.g., the AAA at physiological blood pressure. However, classical continuum mechanics and FE methods assume that constitutive models and the corresponding simulations start from an unloaded, stress-free reference condition.


2010 ◽  
Vol 43 (7) ◽  
pp. 1408-1416 ◽  
Author(s):  
Barry J. Doyle ◽  
Aidan J. Cloonan ◽  
Michael T. Walsh ◽  
David A. Vorp ◽  
Timothy M. McGloughlin

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Joy Roy ◽  
Angela Silveira ◽  
Moritz Liljeqvist Lindquist ◽  
Maggie Folkesson ◽  
Siw Frebelius ◽  
...  

Introduction: Abdominal Aortic Aneurysms (AAA) often contain an intraluminal thrombus (ILT). AAA diameter and ILT volume are associated with growth of the aneurysm. Neutrophils, present in the ILT, contain elastase (NE). NE activity leads to production of fibrin degradation products (FDPs) with a specific epitope [[Unable to Display Character: &#8211;]] XDP. The present study evaluates NE-derived FDPs in aneurysm patients scheduled for elective aortic repair. The purpose of the study is to introduce an additional bio-marker for presence of AAA and possibly risk of rupture by measuring levels of NE derived FDPs in plasma of patients with AAA. Materials and Methods: 42 male patients, undergoing aortic repair for AAA were included. As controls, we collected blood samples from 42 men who attended an AAA screening program but had no AAAs on ultrasound. Computed Tomography (CT) images were available for 34 AAA patients and analyzed using A4 Clinics software (VASCOPS, Austria). Patient demographics, maximum diameter, aortic volume and ILT volume were recorded. Peak wall stress (PWS), peak wall rupture index (PWRI) and mean ILT stress were estimated by Finite Element Analysis using the A4 Clinics software. Plasma levels of elastase digests of cross-linked fibrin (E-XDP) were determined with a sandwich ELISA. Results: E-XDP levels were higher in AAA patients than in age-matched controls (8.5 vs 1.2 U/ml, p<0.0001). E-XDP levels correlated with ILT volume (r = 0.64, p<0.0001), aortic volume (r = 0.64, p<0.0001) and maximum diameter (r = 0.59, p=0.0003). AAA patients with other concomitant peripheral aneurysms had higher E-XDP levels than those with only an AAA (13.6 vs 6.8 U/ml, p=0.028). PWS, PWRI and bleeding signs in the thrombus did not significantly affect E-XDP levels. Interestingly, the mean ILT stress correlated significantly to E-XDP levels (r= 0.45, p=0.008). Conclusions: The study shows that it is feasible to measure E-XDP levels in plasma of patients with AAA and that E-XDP correlates with ILT volume and mean ILT stress. These results support the notion that the resident neutrophils in the ILT can actively lyse fibrin in the ILT, which may decrease ILT strength. E-XDP holds potential as a biomarker of the ILT in AAA patients and needs to be further investigated in AAA rupture risk assessment.


2018 ◽  
Vol 38 (Suppl_1) ◽  
Author(s):  
Moritz Lindquist Liljeqvist ◽  
Rebecka Hultgren ◽  
Christina Villard ◽  
Malin Kronqvist ◽  
Per Eriksson ◽  
...  

2007 ◽  
Vol 98 (08) ◽  
pp. 427-433 ◽  
Author(s):  
Chaoyong Zhu ◽  
Angela Silveira ◽  
Anne-Louise Hemdahl ◽  
Anders Hamsten ◽  
Ulf Hedin ◽  
...  

SummaryIt has been suggested that the intraluminal thrombus of abdominal aortic aneurysms (AAAs) predisposes for AAA enlargement and rupture.The growth of theAAA is dependent on proteolytic degradation of elastin. Here, we analysed whether the neutrophil gelatinase-associated lipocalin (NGAL) is expressed within the thrombus and the aneurysm wall. NGAL can bind to metalloproteinase- 9 (MMP-9) and inhibit its degradation,thereby preserving enzymatic activity. Biopsies were obtained from thrombus- free and thrombus-covered aneurysm wall and the intraluminal thrombus from patients undergoing elective surgery for AAA. Immunohistochemistry and real-time PCR were used to study NGAL and MMP-9 expression. Immunoprecipitation, gel zymography,Western blot and ELISA were used to detect and quantify NGAL/MMP-9 complexes. NGAL was detected in the thrombus, the interface between the thrombus and the underlying wall and in the wall itself.Double staining showed that neutrophils are the major source of NGAL expression. Immunoprecipitation of MMP-9 with antibody against NGAL showed that complexes of NGAL and active MMP-9 were present in thrombus, the interface fluid and the aneurysm wall.Western blot analyses using non-reducing conditions and gel zymography demonstrated that high-molecular-weight complexes of NGAL/MMP-9 were present within the different regions.The concentration of the NGAL/MMP-9 complex was highest in the luminal part of the thrombus. In conclusion, NGAL in complex with activated MMP-9 is present in AAA wall and thrombus. Neutrophil-derived NGAL could enhance the proteolytic activity associated with AAA, but the importance of this mechanism for aneurysm growth remains to be shown.


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