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      Particle-based computational modelling of arterial disease

      1 , 2 , 1
      Journal of The Royal Society Interface
      The Royal Society

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          Abstract

          <p class="first" id="d507610e169">Accumulated glycosaminoglycans (GAGs) can sequester water and induce swelling within the intra-lamellar spaces of the medial layer of an artery. It is increasingly believed that stress concentrations caused by focal swelling can trigger the damage and delamination that is often seen in thoracic aortic disease. Here, we present computational simulations using an extended smoothed particle hydrodynamics approach to examine potential roles of pooled GAGs in initiating and propagating intra-lamellar delaminations. Using baseline models of the murine descending thoracic aorta, we first calculate stress distributions in a healthy vessel. Next, we examine increases in mechanical stress in regions surrounding GAG pools. The simulations show that smooth muscle activation can partially protect the wall from swelling-associated damage, consistent with experimental observations, but the wall can yet delaminate particularly in cases of smooth muscle dysfunction or absence. Moreover, pools of GAGs located at different but nearby locations can extend and coalesce, thus propagating a delamination. These findings, combined with a sensitivity study on the input parameters of the model, suggest that localized swelling can alter aortic mechanics in ways that eventually can cause catastrophic damage within the wall. There is, therefore, an increased need to consider roles of GAGs in aortic pathology. </p>

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          Most cited references33

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          Insights From the International Registry of Acute Aortic Dissection: A 20-Year Experience of Collaborative Clinical Research.

          Acute aortic dissection (AAD) is a life-threatening condition associated with high morbidity and mortality rates, and it remains a challenge to diagnose and treat. The International Registry of Acute Aortic Dissection was established in 1996 with the mission to raise awareness of this condition and provide insights to guide diagnosis and treatment. Since then, >7300 cases have been included from >51 sites in 12 countries. Although presenting symptoms and physical findings have not changed significantly over this period, the use of computed tomography in the diagnosis has increased, and more patients are managed with interventional procedures: surgery in type A AAD and endovascular therapy in type B AAD; with these changes in care, there has been a significant decrease in overall in-hospital mortality in type A AAD but not in type B AAD. Herein, we summarized the key lessons learned from this international registry of patients with AAD over the past 20 years.
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            The International Registry of Acute Aortic Dissection (IRAD)

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              Smoothed Particle Hydrodynamics: Some recent improvements and applications

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                Author and article information

                Journal
                Journal of The Royal Society Interface
                J. R. Soc. Interface
                The Royal Society
                1742-5689
                1742-5662
                December 21 2018
                December 21 2018
                : 15
                : 149
                : 20180616
                Affiliations
                [1 ]Department of Biomedical Engineering, Yale University, New Haven, CT, USA
                [2 ]Departments of Aerospace Engineering and Engineering Mechanics and Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA
                Article
                10.1098/rsif.2018.0616
                6303797
                30958237
                a0b23600-28b1-4526-80f0-6835a7fdc307
                © 2018
                History

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