Hemodynamic simulation of abdominal aortic aneurysm on idealised models: Investigation of stress parameters during disease progression

Philip, Nimmy Thankom; Patnaik, B.S.V.; Sudhir, Bhanu Jayanand

doi:10.1016/j.cmpb.2021.106508

Cited by 27 publications

(13 citation statements)

References 31 publications

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“…Pressure drop along the aorta derives from WSS and turbulent dissipation in vortex regions. In particular, according to [ 23 ], we evaluate the time-averaged WSS (TAWSS):

as an indicator of the total stress on the aortic wall for a complete cardiac cycle. In all models, TAWSS is large at the carotids and subclavian roots ( Figure 19 ) where the flow section narrows, the velocity increases ( Figure 10 and Figure 11 ), and the branch root acts as a flow obstacle.…”

Section: Resultsmentioning

confidence: 99%

“…Comprehension of the pathology evolution can further benefit from evaluation of WSS dynamics [ 23 , 35 , 48 ]. Specifically, despite low TAWSS, vortex flow regions could be prone to aneurysm formation [ 23 ] as a consequence of stress oscillation that elicits structural fatigue. The oscillatory shear index (OSI) evaluates such unsteady WSS effects [ 23 , 25 ]:

…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, despite low TAWSS, vortex flow regions could be prone to aneurysm formation [ 23 ] as a consequence of stress oscillation that elicits structural fatigue. The oscillatory shear index (OSI) evaluates such unsteady WSS effects [ 23 , 25 ]:

…”

Section: Resultsmentioning

confidence: 99%

“…In fact, high WSS values are detected close to the tear [ 18 , 19 , 20 ] and dissection breakdown in association with high pressure levels [ 21 , 22 ]. In addition to WSS and pressure, the Oscillatory Shear Index (OSI) is a valid predictor of WSS oscillation [ 23 , 24 ]. However, it does not take into account WSS intensity, which is instead synthesized through Time-Averaged WSS (TAWSS) [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparative Analysis of Patient-Specific Aortic Dissections through Computational Fluid Dynamics Suggests Increased Likelihood of Degeneration in Partially Thrombosed False Lumen

et al. 2023

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Aortic dissection is a life-threatening vascular disease associated with high rates of morbidity and mortality, especially in medically underserved communities. Understanding patients’ blood flow patterns is pivotal for informing evidence-based treatment as they greatly influence the disease outcome. The present study investigates the flow patterns in the false lumen of three aorta dissections (fully perfused, partially thrombosed, and fully thrombosed) in the chronic phase, and compares them to a healthy aorta. Three-dimensional geometries of aortic true and false lumens (TLs and FLs) are reconstructed through an ad hoc developed and minimally supervised image analysis procedure. Computational fluid dynamics (CFD) is performed through a finite volume unsteady Reynolds-averaged Navier–Stokes approach assuming rigid wall aortas, Newtonian and homogeneous fluid, and incompressible flow. In addition to flow kinematics, we focus on time-averaged wall shear stress and oscillatory shear index that are recognized risk factors for aneurysmal degeneration. Our analysis shows that partially thrombosed dissection is the most prone to false lumen degeneration. In all dissections, the arteries connected to the false lumen are generally poorly perfused. Further, both true and false lumens present higher turbulence levels than the healthy aorta, and critical stagnation points. Mesh sensitivity and a thorough comparison against literature data together support the reliability of the CFD methodology. Image-based CFD simulations are efficient tools to assess the possibility of aortic dissection to lead to aneurysmal degeneration, and provide new knowledge on the hemodynamic characteristics of dissected versus healthy aortas. Similar analyses should be routinely included in patient-specific hemodynamics investigations, to plan and design tailored therapeutic strategies, and to timely assess their effectiveness.

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“…Pressure drop along the aorta derives from WSS and turbulent dissipation in vortex regions. In particular, according to [ 23 ], we evaluate the time-averaged WSS (TAWSS):

Section: Resultsmentioning

confidence: 99%

…”

Section: Resultsmentioning

confidence: 99%

…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparative Analysis of Patient-Specific Aortic Dissections through Computational Fluid Dynamics Suggests Increased Likelihood of Degeneration in Partially Thrombosed False Lumen

et al. 2023

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“…The latest CFD model showed the effect of AAA neck angle on the distribution of WSS [ 12 ]. By constructing six idealized AAA models, the researchers found that the hemodynamic predictor WSS was highly dependent on the shape value (Dmax to height ratio) of AAA [ 13 ]. In this study, we aim to evaluate whether AAA geometric parameters (curvature, neck diameter) except the maximum diameter are associated with WSS.…”

Section: Introductionmentioning

confidence: 99%

Combined Curvature and Wall Shear Stress Analysis of Abdominal Aortic Aneurysm: An Analysis of Rupture Risk Factors

Teng

Zhou

Zhao

et al. 2022

Cardiovasc Intervent Radiol

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Purpose To discuss the risk factors for abdominal aortic aneurysm rupture based on geometric and hemodynamic parameters. Methods We retrospectively reviewed the clinical data of those who were diagnosed with an abdominal aortic aneurysm by computed tomography angiography at our hospital between October 2019 and December 2020. Thirty-five patients were included in the ruptured group (13 patients) and the unruptured group (22 patients). We analyzed the differences and correlations of anatomical factors and hemodynamic parameters between the two groups using computational fluid dynamics based on computed tomography angiography. Results There were significant differences in the maximum diameter [(79.847 ± 10.067) mm vs. (52.320 ± 14.682) mm, P < 0.001], curvature [(0.139 ± 0.050) vs. 0.080 (0.123 − 0.068), P = 0.021], and wall shear stress at the site of maximal blood flow impact [0.549(0.839 − 0.492) Pa vs. (1.378 ± 0.255) Pa, P < 0.001] between the ruptured and unruptured groups, respectively. And in the ruptured group, wall shear stress at the rupture site was significantly different from that at the site of maximal blood flow impact [0.025 (0.049 − 0.018) Pa vs. 0.549 (0.839 − 0.492) Pa, P = 0.001]. Then, the maximum diameter and curvature were associated with rupture (maximum diameter: OR: 1.095, P = 0.003; curvature: OR: 1.142E + 10, P = 0.012). Most importantly, curvature is negatively correlated with wall shear stress (r = − 0.366, P = 0.033). Conclusions Both curvature and wall shear stress can evaluate the rupture risk of aneurysm. Also, curvature can be used as the geometric substitution of wall shear stress.

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Regional Stiffness and Hardening Indices: New Indicators Derived from Multidimensional Dynamic CTA for Aneurysm Risk Assessment

Huang,

Qi,

Cao

et al. 2024

Advanced Science

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Two indices, indicating the regional average stiffness and the pace of strain hardening respectively, are derived from the nonlinear stress–strain behavior obtained from biomechanical analysis of aneurysm. A comprehensive method based on electrocardiographic‐gated multidimensional dynamic computed tomography angiography (MD CTA) is developed for extracting these mechanical characteristics in vivo. The proposed indices are evaluated by 26 cases including 9 healthy, one aortosclerosis, and 16 abdominal aortic aneurysm cases. The difference of SSI and dSSI value between aneurysmal and healthy groups is up to orders in magnitude. Significant correlation of these indices with the clinical indicator of aneurysm diameter is found. Logistic models based on these indices are capable to sharply discriminate the healthy and the aneurysmal arteries with AUC>0.98. This work introduces new tools and new indices for aortic mechanical assessment which may shed light on understanding the mechanical condition, pathological state and eventually benefit clinical decision‐making.

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Hemodynamic simulation of abdominal aortic aneurysm on idealised models: Investigation of stress parameters during disease progression

Cited by 27 publications

References 31 publications

Comparative Analysis of Patient-Specific Aortic Dissections through Computational Fluid Dynamics Suggests Increased Likelihood of Degeneration in Partially Thrombosed False Lumen

Comparative Analysis of Patient-Specific Aortic Dissections through Computational Fluid Dynamics Suggests Increased Likelihood of Degeneration in Partially Thrombosed False Lumen

Combined Curvature and Wall Shear Stress Analysis of Abdominal Aortic Aneurysm: An Analysis of Rupture Risk Factors

Regional Stiffness and Hardening Indices: New Indicators Derived from Multidimensional Dynamic CTA for Aneurysm Risk Assessment

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