Fluid-Solid Interaction Simulation of Flow and Stress Pattern in Thoracoabdominal Aneurysms: A Patient Specific Study

Author(s):  
Alessandro Borghi ◽  
Nigel B. Wood ◽  
Raad H. Mohiaddin ◽  
X. Yun Xu

Thoracoabdominal aneurysm (TA) is a pathology that involves the enlargement of the aortic diameter in the inferior descending thoracic aorta and has risk factors including aortic dissection, aortitis or connective tissue disorders (Webb, T. H. and Williams, G. M. 1999). Abnormal flow patterns and stress on the diseased aortic wall are thought to play an important role in the development of this pathology and the internal wall stress has proved to be more reliable as a predictor of rupture than the maximum diameter for abdominal aortic aneurysms (Fillinger, M. F., et al. 2003). In the present study, two patients with TAs of different maximum diameters were scanned using magnetic resonance imaging (MRI) techniques. Realistic models of the aneurysms were reconstructed from the in vivo MRI data acquired from the patients, and subject-specific flow conditions were applied as boundary conditions. The wall and thrombus were modeled as hyperelastic materials and their properties were derived from the literature. Fully coupled fluid-solid interaction simulations were performed for both cases using ADINA 8.2. Results were obtained for both the flow and wall stress patterns within the aneurysms. The results show that the wall stress distribution and its magnitude are strongly dependent on the 3-D shape of the aneurysm and the distribution of thrombus.

Author(s):  
Avinash Ayyalasomayajula ◽  
Bruce R. Simon ◽  
Jonathan P. Vande Geest

Abdominal aortic aneurysm (AAA) is a progressive dilation of the infrarenal aorta and results in a significant alteration in local hemodynamic environment [1]. While an aneurysmal diameter of 5.5cm is typically classified as being of high risk, recent studies have demonstrated that maximum wall stress could be a better indicator of an AAA rupture than maximum diameter [2]. The wall stress is greatly influenced by the blood pressure, aneurysm diameter, shape, wall thickness and the presence of thrombus. The work done by Finol et al. suggested that hemodynamic pressure variations have an insignificant effect on AAA wall stress and that primarily the shape of the aneurysm determines the stress distribution. They noted that for peak wall stress studies the static pressure conditions would suffice as the in vivo conditions. Wang et al have developed an isotropic hyperelastic constitutive model for the intraluminal thrombus (ILT). Such models have been used to study the stress distributions in patient specific AAAs [3, 4].


Author(s):  
Barry J. Doyle ◽  
Anthony Callanan ◽  
John Killion ◽  
Timothy M. McGloughlin

Abdominal aortic aneurysms (AAAs) remain a significant cause of death in the Western world with over 15,000 deaths per year in the US linked to AAA rupture. Recent research [1] has questioned the use of maximum diameter as a definitive risk parameter as it is now believed that alternative factors may be important in rupture-prediction. Wall stress was shown to be a better predictor than diameter of rupture [1], with biomechanics-based rupture indices [2,3] and asymmetry also reported to have potential clinical applicability [4]. However, the majority of numerical methods used to form these alternative rupture parameters are without rigorous experimental validation, and therefore may not be as accurate as believed. Validated experiments are required in order to convince the clinical community of the worth of numerical tools such as finite element analysis (FEA) in AAA risk-prediction. Strain gauges have been used in the past to determine the strain on an AAA [5], however, the photoelastic method has also proved to be a useful tool in AAA biomechanics [6]. This paper examines the approach using three medium-sized patient-specific AAA cases at realistic pressure loadings.


2008 ◽  
Vol 130 (2) ◽  
Author(s):  
José F. Rodríguez ◽  
Cristina Ruiz ◽  
Manuel Doblaré ◽  
Gerhard A. Holzapfel

Biomechanical studies suggest that one determinant of abdominal aortic aneurysm (AAA) rupture is related to the stress in the wall. In this regard, a reliable and accurate stress analysis of an in vivo AAA requires a suitable 3D constitutive model. To date, stress analysis conducted on AAA is mainly driven by isotropic tissue models. However, recent biaxial tensile tests performed on AAA tissue samples demonstrate the anisotropic nature of this tissue. The purpose of this work is to study the influence of geometry and material anisotropy on the magnitude and distribution of the peak wall stress in AAAs. Three-dimensional computer models of symmetric and asymmetric AAAs were generated in which the maximum diameter and length of the aneurysm were individually controlled. A five parameter exponential type structural strain-energy function was used to model the anisotropic behavior of the AAA tissue. The anisotropy is determined by the orientation of the collagen fibers (one parameter of the model). The results suggest that shorter aneurysms are more critical when asymmetries are present. They show a strong influence of the material anisotropy on the magnitude and distribution of the peak stress. Results confirm that the relative aneurysm length and the degree of aneurysmal asymmetry should be considered in a rupture risk decision criterion for AAAs.


Author(s):  
Barry J. Doyle ◽  
Tim M. McGloughlin

Abdominal aortic aneurysm (AAA) is a permanent dilation of the infrarenal aorta and is defined as having a diameter 50% greater than the original diameter. If left untreated, an AAA will continue to expand until rupture. The maximum diameter is currently the primary indicator of rupture-risk with AAAs > 5.5 cm deemed a likely to rupture. There have, however, been many reports identifying the inadequacies of the maximum diameter criterion to accurately determine the threat of rupture. It is believed by many researchers that there is a need to review the decision of surgical intervention based solely on aneurysm diameter, and rather include other relevant risk factors. These additional risk factors could, for example, include, AAA wall stress, AAA expansion rate, degree of asymmetry, presence of intraluminal thrombus (ILT), and hypertension. The addition of these parameters may aid the surgical decision-making process. A previous report by our group identified the relationship between asymmetry and posterior wall stress in patient-specific cases [1,2] and as over 80% of ruptures occur on the posterior wall [3] this finding may have significant clinical relevance. In this previous report, the study group was limited to 15 cases and asymmetry was only measured in the anterior-posterior plane. This current paper furthers this previous work by increasing the cohort to 40 cases of electively repaired AAAs and also examines 8 cases of ruptured AAAs. The methodology has been improved to now measure asymmetry in all three dimensions (3D).


Author(s):  
Marcel van ’t Veer ◽  
Marcel C. M. Rutten ◽  
Jaap Buth ◽  
Nico H. J. Pijls ◽  
Frans N. van de Vosse

In an effort to better predict the risk of rupture of an abdominal aortic aneurysm (AAA), methods have been developed that comprise more than diameter information alone. Wall stress calculations demonstrated superior results compared to the diameter criterion [1]. Accurate wall stress calculations require patient specific geometry, load, and wall properties of the aneurysm [2]. Usually, values for mechanical properties obtained from in-vitro tensile tests of excised aneurysmal wall material are used for wall stress calculations [3]. For obvious reasons such experiments to obtain vessel properties are impossible to perform in patient specific cases for risk assessment.


2004 ◽  
Vol 1-2 ◽  
pp. 245-250 ◽  
Author(s):  
Arindam Chaudhuri ◽  
Leslie E. Ansdell ◽  
Mohan Adiseshiah ◽  
Anthony J. Grass

Abdominal aortic aneurysms (AAAs) are abnormal aortic dilatations that are prone to rupture, with fatal consequences. Synthetic aneurysm models are being used to assess in vivo stress characteristics of aneurysms before and after surgical reinforcement. This study seeks to assess peak wall stress characteristics in a latex life- like model. A life-like non-axisymmetric latex AAA model, constructed from a 3D computed tomographic reconstruction of a real AAA, was incorporated into a pulsatile flow unit (PFU) to simulate the cardiac output. Strain gauges were placed at the neck (n= 2 x 3), inflection point (the junction of neck and sac, n=4 x 3) and maximum anteroposterior diameter (n=4 x 3). The arterial pressure settings used were 130/90 and 140/100mmHg, termed the low and high setting respectively. Strain readings were obtained at 10Hz over 30 seconds using a data logger. Stress was derived using the relationship between stress and Young’s modulus (E= 5.151872 Nmm-2). Peak wall stresses were statistically analysed over the two pressure settings using ANOVA in Minitab 13. The highest stresses were noted at the inflection point and not at the maximum diameter, as might have been expected. Peak inflection point stress anteriorly measured 394.69 (SD 218.1) x10-4 N/cm2 in the low setting, increasing to 715.39(SD 230.32) in the high setting (p<0.001). Posteriorly, peak wall stress measured as high as 373.61(SD207.24) x10-4 Ncm-2 in the low setting, and increased to 1053.32 (SD 347.01) x10-4 Ncm-2 in the high setting (p<0.001). High posterior stress conforms to in vivo studies. Peak wall stresses were not as high in the sac (range 35.08-204.98 x 10-4 Ncm-2 in the low setting and 54.66- 322.73 x 10-4 Ncm-2 in the high setting). An increase in blood pressure caused an increase only in the anterior and lateral, but not the posterior aspect of the sac (p<0.05). Abdominal aortic wall stress is highest at the inflection point, and is affected by blood pressure, which suggests that it is the area most likely to rupture and is critical to reinforcement of the AAA. These readings are lower than stress noticed in vivo due to the lower E of latex as compared to aneurysmal aorta, which structurally is primarily a multilaminate of elastin and collagen; however, the trends themselves may parallel those that occur in AAAs before and after endovascular or open grafting, and therefore justify artificial stress modelling of AAAs.


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.


2004 ◽  
Vol 126 (4) ◽  
pp. 438-446 ◽  
Author(s):  
Robert A. Peattie ◽  
Tiffany J. Riehle ◽  
Edward I. Bluth

As one important step in the investigation of the mechanical factors that lead to rupture of abdominal aortic aneurysms, flow fields and flow-induced wall stress distributions have been investigated in model aneurysms under pulsatile flow conditions simulating the in vivo aorta at rest. Vortex pattern emergence and evolution were evaluated, and conditions for flow stability were delineated. Systolic flow was found to be forward-directed throughout the bulge in all the models, regardless of size. Vortices appeared in the bulge initially during deceleration from systole, then expanded during the retrograde flow phase. The complexity of the vortex field depended strongly on bulge diameter. In every model, the maximum shear stress occurred at peak systole at the distal bulge end, with the greatest shear stress developing in a model corresponding to a 4.3 cm AAA in vivo. Although the smallest models exhibited stable flow throughout the cycle, flow in the larger models became increasingly unstable as bulge size increased, with strong amplification of instability in the distal half of the bulge. These data suggest that larger aneurysms in vivo may be subject to more frequent and intense turbulence than smaller aneurysms. Concomitantly, increased turbulence may contribute significantly to wall stress magnitude and thereby to risk of rupture.


2019 ◽  
Vol 317 (5) ◽  
pp. H981-H990 ◽  
Author(s):  
Daniel J. Romary ◽  
Alycia G. Berman ◽  
Craig J. Goergen

An abdominal aortic aneurysm (AAA), defined as a pathological expansion of the largest artery in the abdomen, is a common vascular disease that frequently leads to death if rupture occurs. Once diagnosed, clinicians typically evaluate the rupture risk based on maximum diameter of the aneurysm, a limited metric that is not accurate for all patients. In this study, we worked to evaluate additional distinguishing factors between growing and stable murine aneurysms toward the aim of eventually improving clinical rupture risk assessment. With the use of a relatively new mouse model that combines surgical application of topical elastase to cause initial aortic expansion and a lysyl oxidase inhibitor, β-aminopropionitrile (BAPN), in the drinking water, we were able to create large AAAs that expanded over 28 days. We further sought to develop and demonstrate applications of advanced imaging approaches, including four-dimensional ultrasound (4DUS), to evaluate alternative geometric and biomechanical parameters between 1) growing AAAs, 2) stable AAAs, and 3) nonaneurysmal control mice. Our study confirmed the reproducibility of this murine model and found reduced circumferential strain values, greater tortuosity, and increased elastin degradation in mice with aneurysms. We also found that expanding murine AAAs had increased peak wall stress and surface area per length compared with stable aneurysms. The results from this work provide clear growth patterns associated with BAPN-elastase murine aneurysms and demonstrate the capabilities of high-frequency ultrasound. These data could help lay the groundwork for improving insight into clinical prediction of AAA expansion. NEW & NOTEWORTHY This work characterizes a relatively new murine model of abdominal aortic aneurysms (AAAs) by quantifying vascular strain, stress, and geometry. Furthermore, Green-Lagrange strain was calculated with a novel mapping approach using four-dimensional ultrasound. We also compared growing and stable AAAs, finding peak wall stress and surface area per length to be most indicative of growth. In all AAAs, strain and elastin health declined, whereas tortuosity increased.


Sign in / Sign up

Export Citation Format

Share Document