Doyle Barry J, Callanan Anthony, McGloughlin Timothy M
Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical and Aeronautical Engineering and Materials and Surface Science Institute, University of Limerick, Ireland.
Biomed Eng Online. 2007 Oct 19;6:38. doi: 10.1186/1475-925X-6-38.
Aneurysms, in particular abdominal aortic aneurysms (AAA), form a significant portion of cardiovascular related deaths. There is much debate as to the most suitable tool for rupture prediction and interventional surgery of AAAs, and currently maximum diameter is used clinically as the determining factor for surgical intervention. Stress analysis techniques, such as finite element analysis (FEA) to compute the wall stress in patient-specific AAAs, have been regarded by some authors to be more clinically important than the use of a "one-size-fits-all" maximum diameter criterion, since some small AAAs have been shown to have higher wall stress than larger AAAs and have been known to rupture.
A patient-specific AAA was selected from our AAA database and 3D reconstruction was performed. The AAA was then modelled in this study using three different approaches, namely, AAA(SIMP), AAA(MOD) and AAA(COMP), with each model examined using linear and non-linear material properties. All models were analysed using the finite element method for wall stress distributions.
Wall stress results show marked differences in peak wall stress results between the three methods. Peak wall stress was shown to reduce when more realistic parameters were utilised. It was also noted that wall stress was shown to reduce by 59% when modelled using the most accurate non-linear complex approach, compared to the same model without intraluminal thrombus.
The results here show that using more realistic parameters affect resulting wall stress. The use of simplified computational modelling methods can lead to inaccurate stress distributions. Care should be taken when examining stress results found using simplified techniques, in particular, if the wall stress results are to have clinical importance.
动脉瘤,尤其是腹主动脉瘤(AAA),在心血管相关死亡中占很大比例。关于腹主动脉瘤破裂预测和介入手术的最合适工具存在很多争议,目前临床上将最大直径用作手术干预的决定因素。一些作者认为,应力分析技术,如有限元分析(FEA)来计算特定患者腹主动脉瘤的壁应力,比使用“一刀切”的最大直径标准在临床上更重要,因为一些小的腹主动脉瘤已被证明比大的腹主动脉瘤具有更高的壁应力且已知会破裂。
从我们的腹主动脉瘤数据库中选择一个特定患者的腹主动脉瘤并进行三维重建。然后在本研究中使用三种不同方法对该腹主动脉瘤进行建模,即AAA(SIMP)、AAA(MOD)和AAA(COMP),每个模型使用线性和非线性材料特性进行检查。所有模型均使用有限元方法分析壁应力分布。
壁应力结果显示三种方法之间的峰值壁应力结果存在显著差异。当使用更现实的参数时,峰值壁应力显示会降低。还注意到,与没有腔内血栓的相同模型相比,使用最精确的非线性复杂方法建模时,壁应力降低了59%。
此处结果表明,使用更现实的参数会影响所得壁应力。使用简化的计算建模方法可能导致应力分布不准确。在检查使用简化技术获得的应力结果时应谨慎,特别是如果壁应力结果要具有临床重要性。