In-silico investigations of haemodynamic parameters for a blunt thoracic aortic injury case

Abstract

Accounting for 1.5% of thoracic trauma, blunt thoracic aortic injury (BTAI) is a rare disease with a high mortality rate that nowadays is treated mostly via thoracic endovascular aortic repair (TEVAR). Personalised computational models based on fluid–solid interaction (FSI) principals not only support clinical researchers in studying virtual therapy response, but also are capable of predicting eventual outcomes. The present work studies the variation of key haemodynamic parameters in a clinical case of BTAI after successful TEVAR, using a two-way FSI model. The three-dimensional (3D) patient-specific geometries of the patient were coupled with three-element Windkessel model for both prior and post intervention cases, forcing a correct prediction of blood flow over each section. Results showed significant improvement in velocity and pressure distribution after stenting. High oscillatory, low magnitude shear (HOLMES) regions require careful examination in future follow-ups, since thrombus formation was confirmed in some previously clinically reported cases of BTAI treated with TEVAR. The strength of swirling flows along aorta was also damped after stent deployment. Highlighting the importance of haemodynamic parameters in case-specific therapies. In future studies, compromising motion of aortic wall due to excessive cost of FSI simulations can be considered and should be based on the objectives of studies to achieve a more clinical-friendly patient-specific CFD model

Stress Load and Ascending Aortic Aneurysms: An Observational, Longitudinal, Single-Center Study Using Computational Fluid Dynamics

“…Personalized CFD knowledge can clarify hemodynamic metrics and elucidate the prognostic impact of flow patterns, influencing aortic disease management and intervention recommendations to potentially save lives [ 4 , 61 ]. The development of software integration could automate the process, making it more cost-effective and efficient, thereby facilitating the expansion of aortic flow study using CFD and its application as a clinical tool.…”

“…Surgery is planned based on the diameter of the ascending aorta, obtained by imaging, under periodic monitoring [ 1 , 2 , 3 ]. In this context, in recent years, specific geometry studies have emerged to assess the risk of various cardiovascular diseases [ 4 , 5 , 6 ]. However, comparisons of aortic diameter are hampered by the asymmetry of this artery [ 7 ], and it has been shown to be an insufficient risk predictor in patients with AAoA [ 8 ].…”