Belkacemi Djelloul, Tahar Abbes Miloud, Al-Rawi Mohammad, Al-Jumaily Ahmed M, Bachene Sofiane, Laribi Boualem
Mechanics and Energetics Laboratory, Hassiba Ben Bouali University, Chlef 02000, Algeria.
Unité de Développement des Equipements Solaires UDES, CDER, Bousmail, Tipaza 42415, Algeria.
Bioengineering (Basel). 2023 Apr 27;10(5):540. doi: 10.3390/bioengineering10050540.
Abdominal aortic aneurysms (AAA) continue to pose a high mortality risk despite advances in medical imaging and surgery. Intraluminal thrombus (ILT) is detected in most AAAs and may critically impact their development. Therefore, understanding ILT deposition and growth is of practical importance. To assist in managing these patients, the scientific community has been researching the relationship between intraluminal thrombus (ILT) and hemodynamic parameters wall shear stress (WSS) derivatives. This study analyzed three patient-specific AAA models reconstructed from CT scans using computational fluid dynamics (CFD) simulations and a pulsatile non-Newtonian blood flow model. The co-localization and relationship between WSS-based hemodynamic parameters and ILT deposition were examined. The results show that ILT tends to occur in regions of low velocity and time-averaged WSS (TAWSS) and high oscillation shear index (OSI), endothelial cell activation potential (ECAP), and relative residence time (RRT) values. ILT deposition areas were found in regions of low TAWSS and high OSI independently of the nature of flow near the wall characterized by transversal WSS (TransWSS). A new approach is suggested which is based on the estimation of CFD-based WSS indices specifically in the thinnest and thickest ILT areas of AAA patients; this approach is promising and supports the effectiveness of CFD as a decision-making tool for clinicians. Further research with a larger patient cohort and follow-up data are needed to confirm these findings.
尽管医学成像和手术技术有所进步，但腹主动脉瘤（AAA）仍然具有较高的死亡风险。大多数AAA中都能检测到腔内血栓（ILT），它可能对AAA的发展产生关键影响。因此，了解ILT的沉积和生长具有实际意义。为了帮助管理这些患者，科学界一直在研究腔内血栓（ILT）与血流动力学参数壁面切应力（WSS）导数之间的关系。本研究使用计算流体动力学（CFD）模拟和脉动非牛顿血流模型，分析了从CT扫描重建的三个患者特异性AAA模型。研究了基于WSS的血流动力学参数与ILT沉积之间的共定位和关系。结果表明，ILT倾向于出现在低速、时间平均WSS（TAWSS）较低以及振荡剪切指数（OSI）、内皮细胞激活电位（ECAP）和相对停留时间（RRT）值较高的区域。在低TAWSS和高OSI区域发现了ILT沉积区域，这与以横向WSS（TransWSS）为特征的壁附近血流性质无关。提出了一种新方法，该方法基于对AAA患者最薄和最厚ILT区域基于CFD的WSS指数的估计；这种方法很有前景，并支持CFD作为临床医生决策工具的有效性。需要对更多患者队列进行进一步研究并获取随访数据来证实这些发现。
