scholarly journals Examination of Fluid-Structure Interaction in Stent Grafts and its Hemodynamic Implications

Author(s):  
Eric M. Looyenga ◽  
Stephen P. Gent

Every year in the United States, 4,500 deaths occur from abdominal aortic aneurysm (AAA) rupture. Aneurysms develop when the arterial wall weakens. Many risk factors can contribute to aneurysm formation, including age, sex, ethnicity, smoking and hypertension [1]. AAAs are the most common form of aneurysm because the aorta experiences the highest wall shear stress (WSS) of any vessels in the human body. These aneurysms are 5–6% prevalent in men and 1–2% in women, both over 65 years of age [2]. In the aorta, high WSS causes plaque formation, but in peripheral arteries where the flow rate is lower, atherosclerosis can also trigger aneurysm formation.

2013 ◽  
Vol 33 (suppl_1) ◽  
Author(s):  
Xiaohua Dai ◽  
Anandita Arora ◽  
Jianbin Shen ◽  
Hong Jiang ◽  
Li Li

Introduction Abdominal aortic aneurysm (AAA) is a complex vascular disease that causes more than 10,000 deaths each year in the United States. Extensive studies have been performed in search of pharmaceutical treatment but surgical repair still remains the most effective treatment. TGF-β signaling is an important mechanism in the pathogenesis of aneurysms; however, there is debate as to whether its role is protective or destructive. Smad3 is a major intracellular mediator of the canonical pathway of TGF-β signaling. Hypothesis We hypothesize that Smad3-mediated TGF-β signal pathway plays important roles in the pathogenesis of AAA. Methods To test this hypothesis, we analyze the effects of loss of Smad3 on aneurysm formation in the calcium chloride induced AAA model using Smad3 knockout mice. Results Three weeks after calcium chloride treatment, the abdominal aorta displayed increased dilation, forming aneurysms. Histology and immunohistochemistry analyses show increased cell proliferation and enhanced inflammatory cell infiltration in the media and adventitia of the vessel wall. This was accompanied by elastic fibers degradation, increased MMPs expression and reduced expression of smooth muscle markers. Further analysis showed that the expression and nuclear localization of Smad2 and Smad4 was significantly increased. Conclusions These results demonstrate that Smad3-mediated TGF-β signaling plays a protective role in the pathogenesis of AAA and Smad2/Smad4 upregulation is not sufficient to compensate for the loss of Smad3 in this experimental model.


Author(s):  
Frank Gijsen ◽  
Hans Schuurbiers ◽  
Michiel Schaap ◽  
Anton van der Steen ◽  
Jolanda Wentzel

Atherosclerosis is characterized by lipid accumulation in the arterial wall, followed by an inflammatory response. Plaque formation is generally observed near bifurcations in coronary arteries. The composition of atherosclerotic plaques depends on the location, and it was hypothesized that blood flow induced shear stress influences plaque composition2. To study the impact of shear stress on atherosclerotic disease in human coronary arteries, we developed a technique that enables us to generate 3D lumen reconstruction based on multislice computer tomography (MSCT) and intravascular ultrasound (IVUS).We describe two approaches to generate 3D reconstructions of human coronary artery bifurcations and apply them to coronary segments with bifurcations. We will evaluate the effect on shear stress distribution and its relationship to wall thickness.


Author(s):  
Andrea S. Les ◽  
Christopher P. Cheng ◽  
Mary T. Draney Blomme ◽  
C. Alberto Figueroa ◽  
John F. LaDisa ◽  
...  

Abdominal Aortic Aneurysms (AAAs) — the localized enlargement of the abdominal aorta — represent the 13th leading cause of death in the United States. The natural progression of small (3–5 cm) AAAs is 2–6% growth per year until rupture or surgical repair [1]. As AAAs enlarge, adverse hemodynamic conditions (including regions of low mean wall shear stress and high particle residence time) are exacerbated under normal resting conditions.


2012 ◽  
Vol 2012 ◽  
pp. 1-16 ◽  
Author(s):  
David Roy ◽  
Claude Kauffmann ◽  
Sébastien Delorme ◽  
Sophie Lerouge ◽  
Guy Cloutier ◽  
...  

The purpose of this paper is to present the basic principles and relevant advances in the computational modeling of abdominal aortic aneurysms and endovascular aneurysm repair, providing the community with up-to-date state of the art in terms of numerical analysis and biomechanics. Frameworks describing the mechanical behavior of the aortic wall already exist. However, intraluminal thrombus nonhomogeneous structure and porosity still need to be well characterized. Also, although the morphology and mechanical properties of calcifications have been investigated, their effects on wall stresses remain controversial. Computational fluid dynamics usually assumes a rigid artery wall, whereas fluid-structure interaction accounts for artery compliance but is still challenging since arteries and blood have similar densities. We discuss alternatives to fluid-structure interaction based on dynamic medical images that address patient-specific hemodynamics and geometries. We describe initial stresses, elastic boundary conditions, and statistical strength for rupture risk assessment. Special emphasis is accorded to workflow development, from the conversion of medical images into finite element models, to the simulation of catheter-aorta interactions and stent-graft deployment. Our purpose is also to elaborate the key ingredients leading to virtual stenting and endovascular repair planning that could improve the procedure and stent-grafts.


Author(s):  
L. E. Breeher ◽  
Saikrishna Marella ◽  
H. S. Udaykumar ◽  
K. B. Chandran

Research has been conducted by the authors with the objective to produce a computational model that will clearly display the coupled nature of the hemodynamics/fluid mechanics of blood flow and atherosclerotic plaque growth in the human carotid artery. The motivation for this investigation is the serious nature of atherosclerosis. Atherosclerosis is an inflammatory disease, which occurs in medium and large size arteries. Among the many effects stemming from the disease are heart attack, stroke, ischemia, and peripheral vascular disease. In healthy arteries, the collagen and elastin allow the artery to expand and contract with blood flow. This function enables the artery to maintain constant wall shear stress [1]. Plaque existence in the arterial wall results in decreased ductility of the wall, which inhibits the wall from maintaining constant shear stress. Plaque formations along the arterial wall then protrude into the artery, disturbing the blood flow. Characteristics of the fluid flow in the artery are also altered due to the presence of a plaque. Areas of low shear stress and recirculation move downstream from the plaque. These disturbances act not only to further the plaque formation at the site, but also to make the wall around the plaque formation more prone to lesions that could lead to new plaque initiation. Complex characteristics of the blood flow give areas of an artery such as bends and bifurcations a predisposition for the disease, whereas plaques affect blood flow, creating flow patterns that promote new plaque initiation. This interdependency makes atherosclerosis a very serious disease and one which is of great importance in research.


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