Numerical study of hemodynamics after stent implantation during the cardiac cycle

Authors

  • A. Belaghit Laboratory of Applied Biomechanics and Biomaterials, Department of Mechanical Engineering, National Polytechnic School, Maurice Audin of Oran 31000, Algeria. Phone: +213(0)41582066
  • B. Aour Laboratory of Applied Biomechanics and Biomaterials, Department of Mechanical Engineering, National Polytechnic School, Maurice Audin of Oran 31000, Algeria
  • M. Larabi Department of Mechanical Engineering, University of Sciences and Technology of Oran 31000, Algeria
  • A. A. Tadjeddine SCAMRE laboratory, Department of Electrical Engineering, National Polytechnic School, Maurice Audin of Oran 31000, Algeria
  • S. Mebarki Laboratory of Applied Biomechanics and Biomaterials, Department of Mechanical Engineering, National Polytechnic School, Maurice Audin of Oran 31000, Algeria

DOI:

https://doi.org/10.15282/jmes.15.2.2021.07.0632

Keywords:

Blood flow, pressure, aorta, stent, systole, diastole, aneurysm

Abstract

The descending aortic aneurysm is one of the most catastrophic cardiovascular emergencies resulting in high mortality worldwide. Clinical observations have pointed out that stent implantation in the sick aorta should probably allow stabilization of the hemodynamic state of the patient's aorta. To better understand the hemodynamic impact of a stent-treated aneurysm, numerical simulations are used to evaluate hemodynamic parameters. These latter including flow profile, velocity distribution, aortic wall pressure and shear stress, which are difficult to measure in vivo. It should be noted that the numerical modeling assists in medical planning by providing patterns of blood circulation, in particular, the distribution of pressures and shear stresses in the wall. In this context, the pulsatile blood flow in the aneurysmal aorta with stent is studied by CFD (Computational Fluid Dynamics) simulations. Realistic boundary conditions time dependent are prescribed at the level of the different arteries of the complete aorta models. The hemodynamic profile of the aneurysmal aorta with stent was analyzed by contour planes of velocity vectors, pressures and shear stresses at different times during the cardiac cycle. The obtained results made it possible to show the effect of the stent on the improvement of the blood flow by solving the problems of hemodynamic disturbances in the aorta.  The methodology used in this work has revealed detailed and necessary information for the cases studied and shows the interest of the numerical tool for diagnosis and surgery.

References

G. Johansson and J. Swedenborg, "Ruptured abdominal aortic aneurysms: A study of incidence and mortality," British Journal of Surgery, vol. 73, no. 2, pp. 101-103, 1986. doi: 10.1002/bjs.1800730205.

E. K. Shang et al., "Impact of Wall Thickness and Saccular Geometry on the Computational Wall Stress of Descending Thoracic Aortic Aneurysms," vol. 128, no. 11_suppl_1, pp. S157-S162, 2013.

N. Kontopodis, S. Lioudaki, D. Pantidis, G. Papadopoulos, E. Georgakarakos, and C. V. Ioannou, "Advances in determining abdominal aortic aneurysm size and growth," (in eng), World J Radiol, vol. 8, no. 2, pp. 148-58, Feb 28 2016. doi: 10.4329/wjr.v8.i2.148.

R. M. Greenhalgh, L. C. Brown, G. P. Kwong, J. T. Powell, and S. G. Thompson, "Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial," (in eng), Lancet, vol. 364, no. 9437, pp. 843-8, Sep 4-10 2004. doi: 10.1016/s0140-6736(04)16979-1.

R. S. Jackson, D. C. Chang, and J. A. Freischlag, "Comparison of long-term survival after open vs endovascular repair of intact abdominal aortic aneurysm among Medicare beneficiaries," (in eng), Jama, vol. 307, no. 15, pp. 1621-8, Apr 18 2012. doi: 10.1001/jama.2012.453.

M. Prinssen et al., "A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms," (in eng), N Engl J Med, vol. 351, no. 16, pp. 1607-18, Oct 14 2004. doi: 10.1056/NEJMoa042002.

Y. Bryce, P. Rogoff, D. Romanelli, and R. Reichle, "Endovascular repair of abdominal aortic aneurysms: vascular anatomy, device selection, procedure, and procedure-specific complications," (in eng), Radiographics, vol. 35, no. 2, pp. 593-615, Mar-Apr 2015. doi: 10.1148/rg.352140045.

R. J. Hinchliffe, L. Bruijstens, S. T. MacSweeney, and B. D. Braithwaite, "A randomised trial of endovascular and open surgery for ruptured abdominal aortic aneurysm - results of a pilot study and lessons learned for future studies," (in eng), Eur J Vasc Endovasc Surg, vol. 32, no. 5, pp. 506-13; discussion 514-5, Nov 2006. doi: 10.1016/j.ejvs.2006.05.016.

P. Desgranges, H. Kobeiter, Y. Castier, M. Sénéchal, M. Majewski, and A. Krimi, "The Endovasculaire vs Chirurgie dans les Anévrysmes Rompus Protocol trial update," (in eng), J Vasc Surg, vol. 51, no. 1, pp. 267-70, Jan 2010. doi: 10.1016/j.jvs.2009.10.128.

G. H. White, W. Yu, and J. May, "Endoleak--a proposed new terminology to describe incomplete aneurysm exclusion by an endoluminal graft," (in eng), J Endovasc Surg, vol. 3, no. 1, pp. 124-5, Feb 1996. doi: 10.1583/1074-6218(1996)003<0124b:>2.0.CO;2.

D. D. Mendoza et al., "Impact of image analysis methodology on diagnostic and surgical classification of patients with thoracic aortic aneurysms," (in eng), Ann Thorac Surg, vol. 92, no. 3, pp. 904-12, Sep 2011. doi: 10.1016/j.athoracsur.2011.03.130.

L. E. Quint, P. S. Liu, A. M. Booher, K. Watcharotone, and J. D. Myles, "Proximal thoracic aortic diameter measurements at CT: repeatability and reproducibility according to measurement method," (in eng), Int J Cardiovasc Imaging, vol. 29, no. 2, pp. 479-88, Feb 2013. doi: 10.1007/s10554-012-0102-9.

U. Morbiducci et al., "In vivo quantification of helical blood flow in human aorta by time-resolved three-dimensional cine phase contrast magnetic resonance imaging," (in eng), Ann Biomed Eng, vol. 37, no. 3, pp. 516-31, Mar 2009. doi: 10.1007/s10439-008-9609-6.

K. M. Tse, P. Chiu, H. P. Lee, and P. Ho, "Investigation of hemodynamics in the development of dissecting aneurysm within patient-specific dissecting aneurismal aortas using computational fluid dynamics (CFD) simulations," (in eng), J Biomech, vol. 44, no. 5, pp. 827-36, Mar 15 2011. doi: 10.1016/j.jbiomech.2010.12.014.

A. Caballero, S. J. C. E. Laín, and Technology, "A review on computational fluid dynamics modelling in human thoracic aorta," vol. 4, pp. 103-130, 2013.

U. Morbiducci et al., "Outflow conditions for image-based hemodynamic models of the carotid bifurcation: implications for indicators of abnormal flow," (in eng), J Biomech Eng, vol. 132, no. 9, p. 091005, Sep 2010. doi: 10.1115/1.4001886.

U. Morbiducci, R. Ponzini, D. Gallo, C. Bignardi, and G. Rizzo, "Inflow boundary conditions for image-based computational hemodynamics: impact of idealized versus measured velocity profiles in the human aorta," (in eng), J Biomech, vol. 46, no. 1, pp. 102-9, Jan 4 2013. doi: 10.1016/j.jbiomech.2012.10.012.

I. C. Campbell, J. Ries, S. S. Dhawan, A. A. Quyyumi, W. R. Taylor, and J. N. Oshinski, "Effect of inlet velocity profiles on patient-specific computational fluid dynamics simulations of the carotid bifurcation," (in eng), J Biomech Eng, vol. 134, no. 5, p. 051001, May 2012. doi: 10.1115/1.4006681.

C. A. T. and and M. T. Draney, "Experimental and computational methods in cardiovascular fluid mechanics," vol. 36, no. 1, pp. 197-231, 2004. doi: 10.1146/annurev.fluid.36.050802.121944.

J. Lantz, J. Renner, and M. Karlsson, "Wall shear stress in a subject specific human aorta — influence of fluid-structure interaction," vol. 03, no. 04, pp. 759-778, 2011. doi: 10.1142/s1758825111001226.

A. Belaghit, B. Aour, M. Larabi, S. J. J. o. B. Mebarki, Biomaterials, and B. Engineering, "Numerical modeling of blood flow in a healthy aorta and aorta with stent," vol. 39, pp. 13 - 23, 2018.

X. Zhang et al., "Analysis of the formation mechanism and occurrence possibility of Post-Stenotic Dilatation of the aorta by CFD approach," Computer Methods and Programs in Biomedicine, vol. 194, p. 105522, 2020/10/01/ 2020. doi: https://doi.org/10.1016/j.cmpb.2020.105522.

T. Petrila and D. Trif, Basics of Fluid Mechanics and Introduction to Computational Fluid Dynamics, 1 ed. (Numerical Methods and Algorithms, no. 3). Springer US, 2005, pp. XIV, 500.

T. Bodnár and A. Sequeira, "Numerical Simulation of the Coagulation Dynamics of Blood," Computational and Mathematical Methods in Medicine, vol. 9, p. 143803, 1900/01/01 2008. doi: 10.1080/17486700701852784.

P. Bagchi, "Mesoscale simulation of blood flow in small vessels," (in eng), Biophys J, vol. 92, no. 6, pp. 1858-77, Mar 15 2007. doi: 10.1529/biophysj.106.095042.

M. C. Arokiaraj, M. De Beule, and G. De Santis, "A novel sax-stent method in treatment of ascending aorta and aortic arch aneurysms evaluated by finite element simulations," (in eng), J Med Vasc, vol. 42, no. 1, pp. 39-45, Feb 2017. doi: 10.1016/j.jdmv.2017.01.005.

A. Caimi et al., "Prediction of post-stenting biomechanics in coarcted aortas: A pilot finite element study," Journal of Biomechanics, vol. 105, p. 109796, 2020/05/22/ 2020. doi: https://doi.org/10.1016/j.jbiomech.2020.109796.

J. Lantz, "On Aortic Blood Flow Simulations Scale-Resolved Image-Based CFD," Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics, Dissertation Linköping University, Sweden, 2013.

S. W. Fielden, B. K. Fornwalt, M. Jerosch-Herold, R. L. Eisner, A. E. Stillman, and J. N. Oshinski, "A new method for the determination of aortic pulse wave velocity using cross-correlation on 2D PCMR velocity data," (in eng), J Magn Reson Imaging, vol. 27, no. 6, pp. 1382-7, Jun 2008. doi: 10.1002/jmri.21387.

M. S. Olufsen, C. S. Peskin, W. Y. Kim, E. M. Pedersen, A. Nadim, and J. Larsen, "Numerical simulation and experimental validation of blood flow in arteries with structured-tree outflow conditions," (in eng), Ann Biomed Eng, vol. 28, no. 11, pp. 1281-99, Nov-Dec 2000. doi: 10.1114/1.1326031.

P. B. Dobrin, "Mechanics of normal and diseased blood vessels," (in eng), Ann Vasc Surg, vol. 2, no. 3, pp. 283-94, Jul 1988. doi: 10.1016/s0890-5096(07)60016-8.

S. Chandra et al., "Fluid-structure interaction modeling of abdominal aortic aneurysms: the impact of patient-specific inflow conditions and fluid/solid coupling," (in eng), J Biomech Eng, vol. 135, no. 8, p. 81001, Aug 2013. doi: 10.1115/1.4024275.

T. A. Chuter et al., "Endoleak after endovascular repair of abdominal aortic aneurysm," (in eng), J Vasc Surg, vol. 34, no. 1, pp. 98-105, Jul 2001. doi: 10.1067/mva.2001.111487.

R. B. Rutherford and W. C. Krupski, "Current status of open versus endovascular stent-graft repair of abdominal aortic aneurysm," (in eng), J Vasc Surg, vol. 39, no. 5, pp. 1129-39, May 2004. doi: 10.1016/j.jvs.2004.02.027.

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Published

2021-06-10

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[1]
A. Belaghit, B. Aour, M. Larabi, A. A. Tadjeddine, and S. Mebarki, “Numerical study of hemodynamics after stent implantation during the cardiac cycle”, J. Mech. Eng. Sci., vol. 15, no. 2, pp. 8016–8028, Jun. 2021.

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Vol. 15 No. 2 (2021): June 2021

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