Haemodynamics and stresses in abdominal aortic aneurysms: A fluid-structure interaction study into the effect of proximal neck and iliac bifurcation angle

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Title: Haemodynamics and stresses in abdominal aortic aneurysms: A fluid-structure interaction study into the effect of proximal neck and iliac bifurcation angle
Authors: Drewe, CJ
Parker, LP
Kelsey, LJ
Norman, PE
Powell, JT
Doyle, BJ
Item Type: Journal Article
Abstract: Our knowledge of how geometry influences abdominal aortic aneurysm (AAA) biomechanics is still developing. Both iliac bifurcation angle and proximal neck angle could impact the haemodynamics and stresses within AAA. Recent comparisons of the morphology of ruptured and intact AAA show that cases with large iliac bifurcation angles are less likely to rupture than those with smaller angles. We aimed to perform fluid-structure interaction (FSI) simulations on a range of idealised AAA geometries to conclusively determine the influence of proximal neck and iliac bifurcation angle on AAA wall stress and haemodynamics. Peak wall shear stress (WSS) and time-averaged WSS (TAWSS) in the AAA sac region only increased when the proximal neck angle exceeded 30°. Both peak WSS (p < 0.0001) and peak von Mises wall stress (p = 0.027) increased with iliac bifurcation angle, whereas endothelial cell activation potential (ECAP) decreased with iliac bifurcation angle (p < 0.001) and increased with increasing neck angle. These observations may be important as AAAs have been shown to expand, develop thrombus and rupture in areas of low WSS. Here we show that AAAs with larger iliac bifurcation angles have higher WSS, potentially reducing the likelihood of rupture. Furthermore, ECAP was lower in AAA geometries with larger iliac bifurcation angles, implying less likelihood of thrombus development and wall degeneration. Therefore our findings could help explain the clinical observation of lower rupture rates associated with AAAs with large iliac bifurcation angles.
Issue Date: 26-Jul-2017
Date of Acceptance: 16-Jun-2017
ISSN: 0021-9290
Publisher: Elsevier
Start Page: 150
End Page: 156
Journal / Book Title: Journal of Biomechanics
Volume: 60
Copyright Statement: © 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Sponsor/Funder: Department of Health
National Institute for Health Research Health Technology Assessment Programme
Funder's Grant Number: 07/37/64
HTA project 07/37/64
Keywords: Science & Technology
Life Sciences & Biomedicine
Engineering, Biomedical
Abdominal aortic aneurysm
Wall stress
Wall shear stress
Fluid structure interaction
0903 Biomedical Engineering
1106 Human Movement And Sports Science
0913 Mechanical Engineering
Biomedical Engineering
Publication Status: Published
Appears in Collections:Department of Surgery and Cancer

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