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Case Study: Intra-Patient Heterogeneity of Aneurysmal Tissue Properties
KTH, School of Technology and Health (STH). Univ Calgary, Dept Civil Engn, Calgary, AB, Canada.
Univ Calgary, Biomed Engn Grad Program, Calgary, AB, Canada..
Univ Calgary, Biomed Engn Grad Program, Calgary, AB, Canada..
Univ Calgary, Dept Chem & Petr Engn, Calgary, AB, Canada.;Univ Calgary, Ctr Bioengn Res & Educ, Calgary, AB, Canada.;Univ Calgary, Libin Cardiovasc Inst Alberta, Calgary, AB, Canada..
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2018 (English)In: Frontiers in Cardiovascular Medicine, ISSN 2297-055X, Vol. 5, article id 82Article in journal (Refereed) Published
Abstract [en]

Introduction: Current recommendations for surgical treatment of abdominal aortic aneurysms (AAAs) rely on the assessment of aortic diameter as a marker for risk of rupture. The use of aortic size alone may overlook the role that vessel heterogeneity plays in aneurysmal progression and rupture risk. The aim of the current study was to investigate intra-patient heterogeneity of mechanical and fluid mechanical stresses on the aortic wall and wall tissue histopathology from tissue collected at the time of surgical repair. Methods: Finite element analysis (FEA) and computational fluid dynamics (CFD) simulations were used to predict the mechanical wall stress and the wall shear stress fields for a non-ruptured aneurysm 2 weeks prior to scheduled surgery. During open repair surgery one specimen partitioned into different regions was collected from the patient's diseased aorta according to a pre-operative map. Histological analysis and mechanical testing were performed on the aortic samples and the results were compared with the predicted stresses. Results: The preoperative simulations highlighted the presence of altered local hemodynamics particularly at the proximal segment of the left anterior area of the aneurysm. Results from the post-operative assessment on the surgical samples revealed a considerable heterogeneity throughout the aortic wall. There was a positive correlation between elastin fragmentation and collagen content in the media. The tensile tests demonstrated a good prediction of the locally varying constitutive model properties predicted using geometrical variables, i.e., wall thickness and thrombus thickness. Conclusions: The observed large regional differences highlight the local response of the tissue to both mechanical and biological factors. Aortic size alone appears to be insufficient to characterize the large degree of heterogeneity in the aneurysmal wall. Local assessment of wall vulnerability may provide better risk of rupture predictions.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2018. Vol. 5, article id 82
Keywords [en]
abdominal aortic aneurysm, histology, mechanical properties, FEA, CFD
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:kth:diva-233291DOI: 10.3389/fcvm.2018.00082ISI: 000440708000001PubMedID: 30018968Scopus ID: 2-s2.0-85079134331OAI: oai:DiVA.org:kth-233291DiVA, id: diva2:1239631
Funder
Swedish Heart Lung Foundation, G 17 0019141
Note

QC 20180817

Available from: 2018-08-17 Created: 2018-08-17 Last updated: 2020-03-09Bibliographically approved

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