Coupled Hemodynamics and Oxygen Diffusion in Abdominal Aortic Aneurysm: A Computational Sensitivity Study

Springer Science and Business Media LLC - Tập 12 - Trang 166-182 - 2021
Rana Zakerzadeh1, Tanja Cupac1, Nina Dorfner1, Alexander Guy1
1Department of Engineering, Rangos School of Health Sciences, Duquesne University, Pittsburgh, USA

Tóm tắt

Abdominal Aortic Aneurysms (AAA) have extreme medical prevalence as an asymptomatic cause of death in developed countries. The probability of AAA rupture is promoted by the localized oxygen loss in the AAA wall which occurs in part because many AAAs contain a layer called intraluminal thrombus (ILT). Considering this strong clinical association, the purpose of this study is to investigate the key features that constitute to the oxygen diffusion, and therefore hypoxia in AAA. A three-dimensional model of AAA containing ILT is created and numerical simulations are performed to simulate blood flow and oxygen distribution within the AAA. The model accounts for blood flow in the lumen and oxygen transport in the lumen, ILT, and arterial wall. The sub-model of the ILT is fully coupled with the wall sub-model as well as with the subdomain of the blood flow. The sensitivity of the oxygen flow with respect to the parameters of the problem is also analyzed. Model simulations are used to investigate the relation between AAA physical properties, hemodynamics, and oxygen concentration in different geometries of AAA. The results demonstrate that the diameter of the AAA bulge has little effect on the oxygen flow, but that the thickness of the ILT layer has a profound effect. Moreover, a significant sensitivity to the oxygen supply from vasa vasorum and its notable impact on oxygen transport within AAA are observed. The variability of the arterial wall oxygen concentration to the oxygen reaction rate remains however very low. The presence of an ILT significantly impairs oxygen transport from the lumen to the wall. This study confirms that consideration of ILT size and anatomy may be important in considering the severity of a AAA, however, other parameters can also affect thrombus-mediated oxygen delivery within the aneurysmal wall.

Tài liệu tham khảo

Ayyalasomayajula, A., J. P. Vande Geest, and B. R. Simon. Porohyperelastic finite element modeling of abdominal aortic aneurysms. J. Biomech. Eng. 132(10):104502, 2010. https://doi.org/10.1115/1.4002370.

Caputo, M., C. Chiastra, C. Cianciolo, E. Cutri, G. Dubini, J. Gunn, et al. Simulation of oxygen transfer in stented arteries and correlation with in-stent restenosis. Int. J. Numer. Method Biomed. Eng. 29(12):1373–1387, 2013. https://doi.org/10.1002/cnm.2588.

Iannetti, L., G. D’Urso, G. Conoscenti, E. Cutri, R. S. Tuan, M. T. Raimondi, et al. Distributed and lumped parameter models for the characterization of high throughput bioreactors. PLoS ONE. 11(9):e0162774, 2016. https://doi.org/10.1371/journal.pone.0162774.

Kemmerling, E. M. C., and R. A. Peattie. Abdominal aortic aneurysm pathomechanics: current understanding and future directions. Adv. Exp. Med. Biol. 1097:157–179, 2018. https://doi.org/10.1007/978-3-319-96445-4_8.

Kuivaniemi, H., E. J. Ryer, J. R. Elmore, and G. Tromp. Understanding the pathogenesis of abdominal aortic aneurysms. Expert Rev. Cardiovasc. Therapy. 13(9):975–987, 2015. https://doi.org/10.1586/14779072.2015.1074861.

Polzer, S., and J. Bursa (eds.). Poroelastic model of intraluminal thrombus in FEA of aortic aneurysm: 6th World Congress of Biomechanics (WCB 2010). Singapore: Springer, 2010.

Raptis, A., M. Xenos, S. Dimas, A. Giannoukas, N. Labropoulos, D. Bluestein, et al. Effect of macroscale formation of intraluminal thrombus on blood flow in abdominal aortic aneurysms. Comput. Methods Biomech. Biomed. Eng. 19(1):84–92, 2016. https://doi.org/10.1080/10255842.2014.989389.

Riveros F, Martufi G, Gasser TC, Rodriguez JF, editors. Influence of intraluminal thrombus topology on AAA passive mechanics. Comput. Cardiol. 2013; 2013: IEEE.

Salman, H. E., B. Ramazanli, M. M. Yavuz, and H. C. Yalcin. Biomechanical investigation of disturbed hemodynamics-induced tissue degeneration in abdominal aortic aneurysms using computational and experimental techniques. Front. Bioeng. Biotechnol. 7:111, 2019. https://doi.org/10.3389/fbioe.2019.00111.

Sun, N., J. H. Leung, N. B. Wood, A. D. Hughes, S. A. Thom, N. J. Cheshire, et al. Computational analysis of oxygen transport in a patient-specific model of abdominal aortic aneurysm with intraluminal thrombus. Br. J. Radiol. 821:S18–S23, 2009. https://doi.org/10.1259/bjr/89466318.

Swedenborg, J., M. I. Mäyränpää, and P. T. Kovanen. Mast cells: important players in the orchestrated pathogenesis of abdominal aortic aneurysms. Arterioscler. Thromb. Vasc. Biol. 31(4):734–740, 2011.

Takayama, T., and D. Yamanouchi. Aneurysmal disease: the abdominal aorta. Surg. Clin. 93(4):877–891, 2013.

Vorp, D. A., P. C. Lee, D. H. Wang, M. S. Makaroun, E. M. Nemoto, S. Ogawa, et al. Association of intraluminal thrombus in abdominal aortic aneurysm with local hypoxia and wall weakening. J. Vasc. Surg. 34(2):291–299, 2001. https://doi.org/10.1067/mva.2001.114813.

Zakerzadeh, R., T. Cupac, and M. Durka. Oxygen transport in a permeable model of abdominal aortic aneurysm. Comput: Methods Biomech. Biomed. Eng, 2020. https://doi.org/10.1080/10255842.2020.1821193.