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CLC number: O351.2; R732.21

On-line Access: 2021-12-15

Received: 2021-07-03

Revision Accepted: 2021-09-17

Crosschecked: 2021-11-18

Cited: 0

Clicked: 2021

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Maria Antonietta Boniforti

https://orcid.org/0000-0002-8221-2650

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Journal of Zhejiang University SCIENCE A 2021 Vol.22 No.12 P.957-978

http://doi.org/10.1631/jzus.A2100308


On the role of hemodynamics in predicting rupture of the abdominal aortic aneurysm


Author(s):  Maria Antonietta Boniforti, Lorenzo Di Bella, Roberto Magini

Affiliation(s):  Department of Civil, Building, and Environmental Engineering, Sapienza University, Rome 00184, Italy

Corresponding email(s):   antonietta.boniforti@uniroma1.it

Key Words:  Hemodynamics, Computational fluid dynamics, Wall shear stress, Vortex dynamics, Abdominal aortic aneurysm (AAA), Patient-specific modelling


Maria Antonietta Boniforti, Lorenzo Di Bella, Roberto Magini. On the role of hemodynamics in predicting rupture of the abdominal aortic aneurysm[J]. Journal of Zhejiang University Science A, 2021, 22(12): 957-978.

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Abstract: 
hemodynamics plays a crucial role in the growth of an abdominal aortic aneurysm (AAA) and its possible rupture. Due to the serious consequences that arise from the aneurysm rupture, the ability to predict its evolution and the need for surgery are of primary importance in the medical field. Furthermore, the presence of intraluminal thrombus (ILT) strongly affects the evolution of the pathology. In this study, we analyzed the influence of hemodynamics on the growth and possible rupture of AAAs. Numerical investigations of pulsatile non-Newtonian blood flow were performed in six patient-specific AAAs reconstructed from diagnostic images, having different sizes and shapes, and with or without ILT. wall shear stress and vorticity distribution in the bulge and their evolution during the cardiac cycle were analyzed. The results indicate that blood flow dynamics acts synergistically with atherosclerotic degeneration in the development of the disease. The high surface complexity and tortuosity of the aneurysms significantly affect the blood motion, and the presence of inflection in the aneurysm centerline has a noticeable effect on the vortex dynamics. Links between regions of slow recirculating flows, low values of time-averaged wall shear stress, high values of oscillatory shear index, and zones of ILT deposition were found. In the absence of ILT, possible thrombus accumulation areas and consequent aneurysm growth were identified. The findings of this study highlight the importance of hemodynamics in assessing the vulnerability of the aortic wall and underline the crucial role of patient-specific investigations in predicting the rupture of individual aneurysms.

血流动力学在预测腹主动脉瘤破裂中的作用

目的:本文旨在研究血流动力学对腹主动脉瘤(AAA)生长和破裂的影响.腔内血栓(ILT)会强烈影响病理学的演变,因此本研究还考虑了血流动力学和腔内血栓积聚的相互作用.
创新点:1. 研究在主动脉疾病的发展过程中,血流动力学与动脉粥样硬化变性协同作用;2. 分析动脉瘤中心线的拐点、颈部角度和凸起的不对称性对血流动力学的影响.
方法:1. 对6例不同大小和形状、有无腔内血栓的患者特异性腹主动脉瘤进行脉动非牛顿血流的数值研究;2. 根据诊断图像准确地重建患者特定的几何结构;3. 通过分析二维和三维流线演变以及瞬时壁剪应力等值线,描述病变动脉中血流的不稳定性质;4. 计算时间平均血流动力学指标,包括时间平均壁剪切应力和振荡剪切指数.
结论:1. 研究结果表明流动停滞区、低壁面切应力和振荡壁面切应力与腔内血栓的出现存在空间相关性;2. 血管曲率和动脉瘤中心线拐点有利于形成涡流,从而可能导致腔内血栓积聚;3. 血液动力学对主动脉壁脆弱性的评估具有重要作用;此外,患者特异性研究在预测单个动脉瘤破裂时具有关键作用.

关键词:血流动力学;计算流体动力学;壁面切应力;涡流动力学;腹主动脉瘤;患者特定建模

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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