Stress Analysis in AAA does not Predict Rupture Location Correctly in Patients with Intraluminal Thrombus
| Autor: | Nicla Settembre, Lucie Salomon du Mont, Stéphane Avril, Simon Rinckenbach, Fanny Lorandon, Eric Steinmetz |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Male
Patient-Specific Modeling Time Factors Computed Tomography Angiography Aortic Rupture Computed tomography Aortography Risk Assessment Stress (mechanics) Imaging Three-Dimensional Predictive Value of Tests Risk Factors Humans Medicine Intraluminal thrombus In patient Rupture risk Thrombus Aged Retrospective Studies medicine.diagnostic_test business.industry Hemodynamics Models Cardiovascular Biomechanics Thrombosis General Medicine Middle Aged Prognosis medicine.disease Abdominal aortic aneurysm Biomechanical Phenomena Radiographic Image Interpretation Computer-Assisted Surgery Stress Mechanical Cardiology and Cardiovascular Medicine business Nuclear medicine Aortic Aneurysm Abdominal |
| Zdroj: | Annals of Vascular Surgery. 79:279-289 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2021.08.008 |
| Popis: | Objectives A biomechanical approach to the rupture risk of an abdominal aortic aneurysm (AAA) could be a solution to ensure a personalized estimate of this risk. It is still difficult to know in what conditions, the assumptions made by biomechanics, are valid. The objective of this work was to determine the individual biomechanical rupture threshold and to assess the correlation between their rupture sites and the locations of their maximum stress comparing two computed tomography scan (CT) before and at time of rupture. Materials and Methods We included 5 patients who had undergone two CT; one within the last 6 months period before rupture and a second CT scan just before the surgical procedure for the rupture. All DICOM data, both pre- and rupture, were processed following the same following steps: generation of a 3D geometry of the AAA, meshing and computational stress analysis using the finite element method. We used two different modelling scenarios to study the distribution of the stresses, a “wall” model without intraluminal thrombus (ILT) and a “thrombus” model with ILT. Results The average time between the pre-rupture and rupture CT scans was 44 days (22-97). The median of the maximum stresses applied to the wall between the pre-rupture and rupture states were 0.817 MPa (0.555-1.295) and 1.160 MPa (0.633-1.625) for the "wall" model; and 0.365 MPa (0.291-0.753) and 0.390 MPa (0.343-0.819) for the "thrombus" model. There was an agreement between the site of rupture and the location of maximum stress for only one patient, who was the only patient without ILT. Conclusion We observed a large variability of stress values at rupture sites between patients. The rupture threshold strongly varied between individuals depending on the intraluminal thrombus. The site of rupture did not correlate with the maximum stress except for one patient. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|