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Hemodynamics of the Normal Aorta Compared to Fusiform and Saccular Abdominal Aortic Aneurysms with Emphasis on a Potential Thrombus Formation Mechanism

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Abstract

Abdominal Aortic Aneurysms (AAAs), i.e., focal enlargements of the aorta in the abdomen are frequently observed in the elderly population and their rupture is highly mortal. An intra-luminal thrombus is found in nearly all aneurysms of clinically relevant size and multiply affects the underlying wall. However, from a biomechanical perspective thrombus development and its relation to aneurysm rupture is still not clearly understood. In order to explore the impact of blood flow on thrombus development, normal aortas (n = 4), fusiform AAAs (n = 3), and saccular AAAs (n = 2) were compared on the basis of unsteady Computational Fluid Dynamics simulations. To this end patient-specific luminal geometries were segmented from Computerized Tomography Angiography data and five full heart cycles using physiologically realistic boundary conditions were analyzed. Simulations were carried out with computational grids of about half a million finite volume elements and the Carreau–Yasuda model captured the non-Newtonian behavior of blood. In contrast to the normal aorta the flow in aneurysm was highly disturbed and, particularly right after the neck, flow separation involving regions of high streaming velocities and high shear stresses were observed. Naturally, at the expanded sites of the aneurysm average flow velocity and wall shear stress were much lower compared to normal aortas. These findings suggest platelets activation right after the neck, i.e., within zones of pronounced recirculation, and platelet adhesion, i.e., thrombus formation, downstream. This mechanism is supported by recirculation zones promoting the advection of activated platelets to the wall.

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Acknowledgments

We’d like to thank Dr. Piergiorgio Spazzini (INRiM, Italy) for all the helpful discussions about solving procedure and data analysis. This work has been supported by the Young Faculty Grant No. 2006-7568 provided by the Swedish Research Council, VINNOVA and the Swedish Foundation for Strategic Research, and the EC Seventh Framework Programme, Fighting Aneurysmal Disease (FAD-200647) which is gratefully acknowledged.

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Authors and Affiliations

  1. Department of Solid Mechanics, Royal Institute of Technology (KTH), Stockholm, Sweden

    Jacopo Biasetti & T. Christian Gasser

  2. VASCOPS GmbH, Graz, Austria

    Martin Auer

  3. Department of Molecular Medicine and Surgery, Karolinska University Hospital, Stockholm, Sweden

    Ulf Hedin

  4. Department of Radiology, Karolinska University Hospital, Stockholm, Sweden

    Fausto Labruto

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  1. Jacopo Biasetti
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Correspondence to T. Christian Gasser.

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Biasetti, J., Gasser, T.C., Auer, M. et al. Hemodynamics of the Normal Aorta Compared to Fusiform and Saccular Abdominal Aortic Aneurysms with Emphasis on a Potential Thrombus Formation Mechanism. Ann Biomed Eng 38, 380–390 (2010). https://doi.org/10.1007/s10439-009-9843-6

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