Haemodynamics and stresses in abdominal aortic aneurysms: A fluid-structure interaction study into the effect of proximal neck and iliac bifurcation angle

JOURNAL OF BIOMECHANICS

卷:60

Article

Drewe, Corey J.^1,2,3  Parker, Louis P.^1,2,3  Kelsey, Lachlan J.^1,2,3  Norman, Paul E.^1,2,4  Powell, Janet T.⁵  Doyle, Barry J.^1,2,3,6 

[1] Univ Western Australia, QEII Med Ctr, Harry Perkins Inst Med Res, Vasc Engn Lab, Perth, WA, Australia

[2] Univ Western Australia, Ctr Med Res, Perth, WA, Australia

[3] Univ Western Australia, Sch Mech & Chem Engn, Perth, WA, Australia

[4] Univ Western Australia, Sch Surg, Perth, WA, Australia

[5] Imperial Coll London, Vasc Surg Res Grp, London, England

[6] Univ Edinburgh, BHF Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland

关键词: Abdominal aortic aneurysm;    Geometry;    Wall stress;    Wall shear stress;    Fluid structure interaction;   

DOI  :  10.1016/j.jbiomech.2017.06.029

来源: Elsevier

【 摘 要 】

Our knowledge of how geometry influences abdominal aortic aneurysm (AAA) biomechanics is still developing. Both iliac bifurcation angle and proximal neck angle could impact the haemodynamics and stresses within AAA. Recent comparisons of the morphology of ruptured and intact AAA show that cases with large iliac bifurcation angles are less likely to rupture than those with smaller angles. We aimed to perform fluid-structure interaction (FSI) simulations on a range of idealised AAA geometries to conclusively determine the influence of proximal neck and iliac bifurcation angle on AAA wall stress and haemodynamics. Peak wall shear stress (WSS) and time-averaged WSS (TAWSS) in the AAA sac region only increased when the proximal neck angle exceeded 30 degrees. Both peak WSS (p < 0.0001) and peak von Mises wall stress (p = 0.027) increased with iliac bifurcation angle, whereas endothelial cell activation potential (ECAP) decreased with iliac bifurcation angle (p < 0.001) and increased with increasing neck angle. These observations may be important as AAAs have been shown to expand, develop thrombus and rupture in areas of low WSS. Here we show that AAAs with larger iliac bifurcation angles have higher WSS, potentially reducing the likelihood of rupture. Furthermore, ECAP was lower in AAA geometries with larger iliac bifurcation angles, implying less likelihood of thrombus development and wall degeneration. Therefore our findings could help explain the clinical observation of lower rupture rates associated with AAAs with large iliac bifurcation angles. (C) 2017 Elsevier Ltd. All rights reserved.

【 授权许可】

Free