In-vivo blood flow parameters can predict at-risk aortic aneurysms and dissection: a comprehensive biomechanics model

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Salmasi ◽  
O.A Jarral ◽  
S Pirola ◽  
S Sasidharan ◽  
J Pepper ◽  
...  
Keyword(s):  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Risk Prediction ◽  
Aortic Wall ◽  
Tissue Mechanics ◽  
Aortic Aneurysms ◽  
Funding Source ◽  
Wall Shear

Abstract Background Abnormal blood flow patterns can alter the material properties of the thoracic aorta via altered vascular biology and tissue biomechanics. In-vivo haemodynamic assessment of the aorta is yet to penetrate clinical practice due to our limited understanding of its effect on aortic wall properties. The decision for surgical treatment is based on size thresholds, limited to a single measurement of aortic diameter from routine imaging, although many aortic dissections (40–60%) occur below these size thresholds. This multi-centre study aims to assess the clinical utility of biomechanics principles in thoracic aortic aneurysm (TAA) risk rupture prediction using a substantial sample size. Methods Fifty-five patients undergoing surgery for root or ascending TAA were recruited from five cardiac centres. Bicuspid aortic valves and connective tissue disease were excluded from this study.Haemodynamic assessment Pre-operative 4-dimensional flow magnetic resonance imaging (4D-MRI) were conducted. Direct 4D-flow analysis and computational fluid dynamics (CFD) were performed creating detailed wall shear stress (WSS) maps across the whole aneurysms. Aortic wall assessment The aneurysmal aortic sample was obtained from surgery and subjected to region specific uniaxial failure tests in the circumferential and longitudinal directions, as well as delamination testing within the aortic media. Whole aneurysm histological characterisation was also conducted using computational pathology techniques. Blood flow, tissue mechanics and microstructural properties were used to develop a risk prediction model with assessment of elastin, collagen and smooth muscle cell composition, as well as failure strain assessment and dissection energy function. Results Outcomes of mechanical properties were: Young's Elastic Modulus as a measure of aortic stiffness (0.85 MPa ±0.69), as well as maximal tensile strength (0.49 MPa ± 0.36), which demonstrated reduced aortic wall strength in the outer curvature. This correlated with increased wall shear stress (WSS) (up to 10 Pa) and flow velocity (up to 43 l/min). Regions of abnormal flow and tissue mechanics correlated significantly with degraded medial microstructure (elastin abundance: 34 vs 66%; collagen abundance 26 vs 57%, p<0.05). Conclusions CFD modelling has the potential to provide a risk prediction of acute events in TAA beyond the current size classification, as validated by altered aortic tissue properties. Future longitudinal studies are warranted to validate this methods in moderately enlarging thoracic aortas. Flow, mechanical, histology properties Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): NIHR Imperial College BRC

Design and Analysis of a Shear Stress Sensor for Microcirculation Investigations (Invited Paper)

2003 ◽  
Author(s):  
Risa Robinson ◽  
Lynn Fuller ◽  
Harvey Palmer ◽  
Mary Frame
Keyword(s):  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Computational Technique ◽  
Flow Modification ◽  
Stress Sensors ◽  
Shear Stress Sensors ◽  
Wall Shear

Blood flow regulation in the microvascular network has been investigated by means of computational fluid dynamics, in vivo particle tracking and microchannel models. It is evident from these studies that shear stress along the wall is a key factor in the communication network that results in blood flow modification, yet current methods for shear stress determination are acknowledged to be imprecise. Micromachining technology allows for the development of implantable shear stress sensors that will enable us to monitor wall shear stress at multiple locations in arteriole bifurcations. In this study, a microchannel was employed as an in vitro model of a microvessel. Thermal shear stress sensors were used to mimic the endothelial cells that line the vessel wall. A three dimensional computational model was created to simulate the system’s thermal response to the constant temperature control circuit and related wall shear stress. The model geometry included a silicon wafer section with all the fabrication layers — silicon dioxide, poly silicon resistor, silicon nitride — and a microchannel with cross section 17 μm × 17 μm. This computational technique was used to optimize the dimensions of the system for a 0.01 Reynolds number flow at room temperature in order to reduce the amount of heat lost to the substrate and to predict and maximize the signal response. Results of the design optimization are presented and the fabrication process discussed.

The Effect of Asymmetry in Abdominal Aortic Aneurysms Under Physiologically Realistic Pulsatile Flow Conditions

2003 ◽  
Vol 125 (2) ◽  
pp. 207-217 ◽  
Author(s):  
E. A. Finol ◽  
K. Keyhani ◽  
C. H. Amon
Keyword(s):  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Pulsatile Flow ◽  
Reynolds Numbers ◽  
Secondary Flows ◽  
Aortic Aneurysms ◽  
Pulsatile Blood Flow ◽  
Abdominal Aortic ◽  
Wall Shear

In the abdominal segment of the human aorta under a patient’s average resting conditions, pulsatile blood flow exhibits complex laminar patterns with secondary flows induced by adjacent branches and irregular vessel geometries. The flow dynamics becomes more complex when there is a pathological condition that causes changes in the normal structural composition of the vessel wall, for example, in the presence of an aneurysm. This work examines the hemodynamics of pulsatile blood flow in hypothetical three-dimensional models of abdominal aortic aneurysms (AAAs). Numerical predictions of blood flow patterns and hemodynamic stresses in AAAs are performed in single-aneurysm, asymmetric, rigid wall models using the finite element method. We characterize pulsatile flow dynamics in AAAs for average resting conditions by means of identifying regions of disturbed flow and quantifying the disturbance by evaluating flow-induced stresses at the aneurysm wall, specifically wall pressure and wall shear stress. Physiologically realistic abdominal aortic blood flow is simulated under pulsatile conditions for the range of time-average Reynolds numbers 50⩽Rem⩽300, corresponding to a range of peak Reynolds numbers 262.5⩽Repeak⩽1575. The vortex dynamics induced by pulsatile flow in AAAs is depicted by a sequence of four different flow phases in one period of the cardiac pulse. Peak wall shear stress and peak wall pressure are reported as a function of the time-average Reynolds number and aneurysm asymmetry. The effect of asymmetry in hypothetically shaped AAAs is to increase the maximum wall shear stress at peak flow and to induce the appearance of secondary flows in late diastole.

Numerical Simulation of Fluid-Induced Vibration and Wall Shear Stress in Fusi/Form Cerebral Aneurysm: Newtonian and Non-Newtonian Fluid

2006 ◽  
Author(s):  
Yong Hyun Kim ◽  
Joon Sand Lee ◽  
Xin Wu
Keyword(s):  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Newtonian Fluid ◽  
Stress Gradient ◽  
In Vivo Studies ◽  
Rupture Area ◽  
Study Results ◽  
Wall Shear

Vascular techniques have been used for curing the aneurysm, but the reason for the occurrence of aneurysms can not be known using these techniques. These techniques are usually used for preventing a significant situation such as rupture of an aneurysm. In our study, blood flow effects with or without vascular techniques inside an aneurysm were analyzed with computational fluid dynamics (CFD). Important hemodynamic quantities like wall shear stress and pressure in vessel are difficult to measure in-vivo. Blood flow is assumed to be Newtonian fluid. But it actually consists of platelets, so it is also considered a non-Newtonian fluid in this study. Results of the numerical model were used to compare and analyze fluid characteristics with experimental data. Using the flow characteristics (wall shear stress (WSS), wall shear stress gradient (WSSG)), the rupture area was identified to be located in the distal area. However, the rupture area, in vivo studies, was observed to be present at a different location. During pulsatile flow, vibration induced by flow is implicated by weakening of the artery wall and affects more than shear stress. After adapting the fluid-induced vibration, the rupture area in aneurysm is found to be located in the same area as the in-vivo result. Since smaller inflow and low WSS provide the effect of the distal neck, the vibration provides more effects in dome area. In this study it has been found that the effect of shear stress on the rupture of aneurysm is less than the effect of vibration. In the case of non-Newtonian fluid, vibration induced by flow also has more effects than WSS and WSSG. The simulation results gave detailed information about hemodynamics under physiological pulsatile inlet condition.

Alterations in wall shear stress predict sites of neointimal hyperplasia after stent implantation in rabbit iliac arteries

2005 ◽  
Vol 288 (5) ◽  
pp. H2465-H2475 ◽  
Author(s):  
John F. LaDisa ◽  
Lars. E. Olson ◽  
Robert C. Molthen ◽  
Douglas A. Hettrick ◽  
Phillip F. Pratt ◽  
...  
Keyword(s):  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Iliac Artery ◽  
Stent Implantation ◽  
Neointimal Hyperplasia ◽  
Three Dimensional ◽  
Iliac Arteries ◽  
Wall Shear

Restenosis resulting from neointimal hyperplasia (NH) limits the effectiveness of intravascular stents. Rates of restenosis vary with stent geometry, but whether stents affect spatial and temporal distributions of wall shear stress (WSS) in vivo is unknown. We tested the hypothesis that alterations in spatial WSS after stent implantation predict sites of NH in rabbit iliac arteries. Antegrade iliac artery stent implantation was performed under angiography, and blood flow was measured before casting 14 or 21 days after implantation. Iliac artery blood flow domains were obtained from three-dimensional microfocal X-ray computed tomography imaging and reconstruction of the arterial casts. Indexes of WSS were determined using three-dimensional computational fluid dynamics. Vascular histology was unchanged proximal and distal to the stent. Time-dependent NH was localized within the stented region and was greatest in regions exposed to low WSS and acute elevations in spatial WSS gradients. The lowest values of WSS spatially localized to the stented area of a theoretical artery progressively increased after 14 and 21 days as NH occurred within these regions. This NH abolished spatial disparity in distributions of WSS. The results suggest that stents may introduce spatial alterations in WSS that modulate NH in vivo.

scholarly journals In vivo blood flow and wall shear stress measurements in the vitelline network

2008 ◽  
Vol 45 (4) ◽  
pp. 703-713 ◽  
Author(s):  
C. Poelma ◽  
P. Vennemann ◽  
R. Lindken ◽  
J. Westerweel
Keyword(s):  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Stress Measurements ◽  
Wall Shear

In Vivo Quantification of Blood Flow and Wall Shear Stress in the Human Abdominal Aorta During Lower Limb Exercise

2002 ◽  
Vol 30 (3) ◽  
pp. 402-408 ◽  
Author(s):  
Charles A. Taylor ◽  
Christopher P. Cheng ◽  
Leandro A. Espinosa ◽  
Beverly T. Tang ◽  
David Parker ◽  
...  
Keyword(s):  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Abdominal Aorta ◽  
Lower Limb ◽  
Lower Limb Exercise ◽  
Wall Shear ◽  
Human Abdominal Aorta ◽  
Limb Exercise

Blood Flow in Abdominal Aortic Aneurysms: Pulsatile Flow Hemodynamics

2001 ◽  
Vol 123 (5) ◽  
pp. 474-484 ◽  
Author(s):  
Ender A. Finol ◽  
Cristina H. Amon
Keyword(s):  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Pulsatile Flow ◽  
Peak Flow ◽  
Abdominal Aortic Aneurysms ◽  
Reynolds Numbers ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Wall Shear

Numerical predictions of blood flow patterns and hemodynamic stresses in Abdominal Aortic Aneurysms (AAAs) are performed in a two-aneurysm, axisymmetric, rigid wall model using the spectral element method. Physiologically realistic aortic blood flow is simulated under pulsatile conditions for the range of time-averaged Reynolds numbers 50⩽Rem⩽300, corresponding to a range of peak Reynolds numbers 262.5⩽Repeak⩽1575. The vortex dynamics induced by pulsatile flow in AAAs is characterized by a sequence of five different flow phases in one period of the flow cycle. Hemodynamic disturbance is evaluated for a modified set of indicator functions, which include wall pressure pw, wall shear stress τw, and Wall Shear Stress Gradient (WSSG). At peak flow, the highest shear stress and WSSG levels are obtained downstream of both aneurysms, in a pattern similar to that of steady flow. Maximum values of wall shear stresses and wall shear stress gradients obtained at peak flow are evaluated as a function of the time-average Reynolds number resulting in a fourth order polynomial correlation. A comparison between predictions for steady and pulsatile flow is presented, illustrating the importance of considering time-dependent flow for the evaluation of hemodynamic indicators.

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