4.5 Article

Prediction of wall stress and oxygen flow in patient-specific abdominal aortic aneurysms: the role of intraluminal thrombus

Journal

BIOMECHANICS AND MODELING IN MECHANOBIOLOGY
Volume 21, Issue 6, Pages 1761-1779

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s10237-022-01618-w

Keywords

Abdominal aortic aneurysm (AAA); Intraluminal thrombus (ILT); Patient-specific; Hypoxia; Arterial wall stress; Fluid; Structure interaction

Funding

  1. Samuel and Emma Winters Foundation
  2. NSF [DMS 1912908, DCSD 1934300, CBET 2138225]

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This study investigates the biomechanical role of intraluminal thrombus (ILT) in abdominal aortic aneurysm (AAA). The results demonstrate that while ILT can reduce wall stress, it significantly decreases oxygen transport within the tissue, leading to wall hypoxia.
In this study, the biomechanical role of intraluminal thrombus (ILT) in an abdominal aortic aneurysm (AAA) is investigated. The implications of ILT in AAA are controversial in literature. Previous studies have demonstrated that ILT provides a biomechanical advantage by decreasing wall stress, whereas other studies have associated ILT with inhibiting oxygen transport and inducing aortic wall weakening. Therefore, we sought to explore the connection between ILT, mechanical stresses, and oxygen flow in different geometries of patient-specific aneurysms with varying ILT morphologies. The objective is to investigate the extent to which ILT influences the prediction of aneurysmal wall stresses that are associated with rupture, as well as oxygen concentrations to measure tissue oxygen deprivation. Three patient-specific AAA geometries are considered, and two models, one with ILT and one without ILT, are created for each patient to assess the effect of ILT presence. A fluid-structure interaction approach is used to couple the blood flow, wall deformation, and oxygen mass transport. Results are presented for hemodynamics patterns, wall stress measures, and oxygen metrics within the arterial wall. While ILT is found to reduce wall stress, simulations confirm that ILT decreases oxygen transport within the tissue significantly, leading to wall hypoxia.

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