Biomechanical Investigation of Disturbed Hemodynamics-Induced Tissue Degeneration in Abdominal Aortic Aneurysms Using Computational and Experimental Techniques

Abdominal aortic aneurysm (AAA) is the dilatation of the aorta beyond 50% of the normal vessel diameter. It is reported that 4-8% of men and 0.5-1% of women above 50 years of age bear an AAA and it accounts for ~15,000 deaths per year in the United States alone. If left untreated, AAA might gradually expand until rupture; the most catastrophic complication of the aneurysmal disease that is accompanied by a striking overall mortality of 80%. The precise mechanisms leading to AAA rupture remains unclear. Therefore, characterization of disturbed hemodynamics within AAAs will help to understand the mechanobiological development of the condition which will contribute to novel therapies for the condition. Due to geometrical complexities, it is challenging to directly quantify disturbed flows for AAAs clinically. Two other approaches for this investigation are computational modeling and experimental flow measurement. In computational modeling, the problem is first defined mathematically, and the solution is approximated with numerical techniques to get characteristics of flow. In experimental flow measurement, once the setup providing physiological flow pattern in a phantom geometry is constructed, velocity measurement system such as particle image velocimetry (PIV) enables characterization of the flow. We witness increasing number of applications of these complimentary approaches for AAA investigations in recent years. In this paper, we outline the details of computational modeling procedures and experimental settings and summarize important findings from recent studies, which will help researchers for AAA investigations and rupture mechanics.

A 3D MODEL FOR MURAL-CELL-MEDIATED DESTRUCTIVE REMODELING DURING EARLY DEVELOPMENT OF A CEREBRAL ANEURYSM

Development of a diagnostic tool for predicting the behavior of cerebral aneurysms was the inspiration of many research groups in recent years. In the present study a fluid–solid-growth (FSG) model for the early development of a cerebral aneurysm was presented in a 3D model of the internal carotid artery (ICA). This model is the result of two parallel mechanisms: first, defining arterial wall as a living tissue with the ability of degradation, growth and remodeling and second, full coupling of the wall and the blood flow. Taking into account the shear dependent nature of elastin degradation and mural-cell-mediated destructive activities, here, the degradation process has been linked to high effective stress of the vascular wall. The evolving properties of the elastinous and collagenous constituents have been predicted during the early development of the aneurysm and the code is applicable to more complicated aneurismal growth models.

Investigation of material modeling in fluid-structure interaction analysis of an idealized three-layered abdominal aorta: aneurysm initiation and fully developed aneurysms

Different material models for an idealized three-layered abdominal aorta are compared using computational techniques to study aneurysm initiation and fully developed aneurysms. The computational model includes fluid-structure interaction (FSI) between the blood vessel and the blood. In order to model aneurysm initiation, the medial region was degenerated to mimic the medial loss occurring in the inception of an aneurysm. Various cases are considered in order to understand their effects on the initiation of an abdominal aortic aneurysm. The layers of the blood vessel were modeled using either linear elastic materials or Mooney-Rivlin (otherwise known as hyperelastic) type materials. The degenerated medial region was also modeled in either linear elastic or hyperelastic-type materials and assumed to be in the shape of an arc with a thin width or a circular ring with different widths. The blood viscosity effect was also considered in the initiation mechanism. In addition, dynamic analysis of the blood vessel was performed without interaction with the blood flow by applying time-dependent pressure inside the lumen in a three-layered abdominal aorta. The stresses, strains, and displacements were compared for a healthy aorta, an initiated aneurysm and a fully developed aneurysm. The study shows that the material modeling of the vessel has a sizable effect on aneurysm initiation and fully developed aneurysms. Different material modeling of degeneration regions also affects the stress-strain response of aneurysm initiation. Additionally, the structural analysis without considering FSI (called noFSI) overestimates the peak von Mises stress by 52% at the interfaces of the layers.

Microstructural modelling of cerebral aneurysm evolution through effective stress mediated destructive remodelling

Recently, researchers have shown an increased interest in the biomechanical modelling of cerebral aneurysm development. In the present study a fluid-solid-growth model for the formation of a fusiform aneurysm has been presented in an axi-symmetric geometry of the internal carotid artery. This model is the result of two parallel mechanisms: first, defining arterial wall as a living tissue with the ability of degradation, growth and remodelling and second, full coupling of the wall and the blood flow. Here for the first time the degradation of elastin has been defined as a function of vascular wall effective stress to take into account the shear dependent nature of degradation and the mural-cell-mediated destructive activities. The model has been stabilized in size and mechanical properties and is consistent with other computational or clinical studies. Furthermore, the evolving microstructural properties of the wall during the evolution process have been predicted.

COMPUTATIONAL MODELING OF FORMATION OF A CEREBRAL ANEURYSM UNDER THE INFLUENCE OF SMOOTH MUSCLE CELL RELAXATION

The mechanics of cerebral aneurysm pathogenesis, evolution and rupture are not yet well understood. This paper presents a numerical analysis of the formation of a saccular cerebral aneurysm in for the first time in a 3D model of the basilar artery bifurcation under normal and hypertensive blood pressure. Due to the excessive endothelium derived nitric oxide produced in high wall shear stress, we assumed that smooth muscle cell relaxation is the origin of the aneurysm formation. Arterial wall remodeling under constant tension was considered to be the other mechanism of disease evolution. The wall was constructed from two elastic and hyperelastic isotropic regions. The flow was considered steady, laminar, Newtonian, and incompressible. The fully coupled fluid and structure models were solved with the finite elements package ADINA 8.5. The wall shear stress, effective stress and deformation distributions under normal and hypertensive blood pressure were compared to a healthy bifurcation. The model shows that although the malfunction of the endothelial cell layer and the corresponding smooth muscle cell-related loss of vascular tone is important to the inception of the disease; A saccular aneurysm may not be formed by this mechanism alone, and also requires the fiber-related arterial wall remodeling for further development.

Modelling evolution and the evolving mechanical environment of saccular cerebral aneurysms

A fluid-solid-growth (FSG) model of saccular cerebral aneurysm evolution is developed. It utilises a realistic two-layered structural model of the internal carotid artery and explicitly accounts for the degradation of the elastinous constituents and growth and remodelling (G&R) of the collagen fabric. Aneurysm inception is prescribed: a localised degradation of elastin results in a perturbation in the arterial geometry; the collagen fabric adapts, and the artery achieves a new homeostatic configuration. The perturbation to the geometry creates an altered haemodynamic environment. Subsequent degradation of elastin is explicitly linked to low wall shear stress (WSS) in a confined region of the arterial domain. A sidewall saccular aneurysm develops, the collagen fabric adapts and the aneurysm stabilises in size. A quasi-static analysis is performed to determine the geometry at diastolic pressure. This enables the cyclic stretching of the tissue to be quantified, and we propose a novel index to quantify the degree of biaxial stretching of the tissue. Whilst growth is linked to low WSS from a steady (systolic) flow analysis, a pulsatile flow analysis is performed to compare steady and pulsatile flow parameters during evolution. This model illustrates the evolving mechanical environment for an idealised saccular cerebral aneurysm developing on a cylindrical parent artery and provides the guidance to more sophisticated FSG models of aneurysm evolution which link G&R to the local mechanical stimuli of vascular cells.

Coupling the Hemodynamic Environment to the Evolution of Cerebral Aneurysms: Computational Framework and Numerical Examples

The physiological mechanisms that give rise to the inception and development of a cerebral aneurysm are accepted to involve the interplay between the local mechanical forces acting on the arterial wall and the biological processes occurring at the cellular level. In fact, the wall shear stresses (WSSs) that act on the endothelial cells are thought to play a pivotal role. A computational framework is proposed to explore the link between the evolution of a cerebral aneurysm and the influence of hemodynamic stimuli that act on the endothelial cells. An aneurysm evolution model, which utilizes a realistic microstructural model of the arterial wall, is combined with detailed 3D hemodynamic solutions. The evolution of the blood flow within the developing aneurysm determines the distributions of the WSS and the spatial WSS gradient (WSSG) that act on the endothelial cell layer of the tissue. Two illustrative examples are considered: Degradation of the elastinous constituents is driven by deviations of WSS or the WSSG from normotensive values. This model provides the basis to further explore the etiology of aneurysmal disease.