A novel method for non-invasively detecting the severity and location of aortic aneurysms

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Abstract

The influence of an aortic aneurysm on blood flow waveforms is well established, but how to exploit this link for diagnostic purposes still remains challenging. This work uses a combination of experimental and computational modelling to study how aneurysms of various size affect the waveforms. Experimental studies are carried out on fusiform-type aneurysm models, and a comparison of results with those from a one-dimensional fluid–structure interaction model shows close agreement. Further mathematical analysis of these results allows the definition of several indicators that characterize the impact of an aneurysm on waveforms. These indicators are then further studied in a computational model of a systemic blood flow network. This demonstrates the methods’ ability to detect the location and severity of an aortic aneurysm through the analysis of flow waveforms in clinically accessible locations. Therefore, the proposed methodology shows a high potential for non-invasive aneurysm detectors/monitors.

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The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial.

Ella L. Kim, Mitchell G. Thompson, Jeremy Day … (2002)

Opposing views have been published on the importance of ultrasound screening for abdominal aortic aneurysms. The Multicentre Aneurysm Screening Study was designed to assess whether or not such screening is beneficial. A population-based sample of men (n=67800) aged 65-74 years was enrolled, and each individual randomly allocated to either receive an invitation for an abdominal ultrasound scan (invited group, n=33839) or not (control group, n=33961). Men in whom abdominal aortic aneurysms (> or =3 cm in diameter) were detected were followed-up with repeat ultrasound scans for a mean of 4.1 years. Surgery was considered on specific criteria (diameter > or =5.5 cm, expansion > or =1 cm per year, symptoms). Mortality data were obtained from the Office of National Statistics, and an intention-to-treat analysis was based on cause of death. Quality of life was assessed with four standardised scales. The primary outcome measure was mortality related to abdominal aortic aneurysm. 27147 of 33839 (80%) men in the invited group accepted the invitation to screening, and 1333 aneurysms were detected. There were 65 aneurysm-related deaths (absolute risk 0.19%) in the invited group, and 113 (0.33%) in the control group (risk reduction 42%, 95% CI 22-58; p=0.0002), with a 53% reduction (95% CI 30-64) in those who attended screening. 30-day mortality was 6% (24 of 414) after elective surgery for an aneurysm, and 37% (30 of 81) after emergency surgery. Our results provide reliable evidence of benefit from screening for abdominal aortic aneurysms.

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Computer simulation of arterial flow with applications to arterial and aortic stenoses.

N Stergiopulos, T Rogge, D. Craig Young (1992)

A computer model for simulating pressure and flow propagation in the human arterial system is developed. The model is based on the one-dimensional flow equations and includes nonlinearities arising from geometry and material properties. Fifty-five arterial segments, representing the various major arteries, are combined to form the model of the arterial system. Particular attention is paid to the development of peripheral pressure and flow pulses under normal flow conditions and under conditions of arterial and aortic stenoses. Results show that the presence of severe arterial stenoses significantly affects the nature of the distal pressure and flow pulses. Aortic stenoses also have a profound effect on central and peripheral pressure pulse formation. Comparison with the published experimental data suggests that the model is capable of simulating arterial flow under normal flow conditions as well as conditions of stenotic obstructions in a satisfactory manner.

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Modelling the circle of Willis to assess the effects of anatomical variations and occlusions on cerebral flows.

Matthew S. Byrd, Jason S Sherwin, K. Parker … (2006)

Blood flow in the circle of Willis (CoW) is modelled using the 1-D equations of pressure and flow wave propagation in compliant vessels. The model starts at the left ventricle and includes the largest arteries that supply the CoW. Based on published physiological data, it is able to capture the main features of pulse wave propagation along the aorta, at the brachiocephalic bifurcation and throughout the cerebral arteries. The collateral ability of the complete CoW and its most frequent anatomical variations is studied in normal conditions and after occlusion of a carotid or vertebral artery (VA). Our results suggest that the system does not require collateral pathways through the communicating arteries to adequately perfuse the brain of normal subjects. The communicating arteries become important in cases of missing or occluded vessels, the anterior communicating artery (ACoA) being a more critical collateral pathway than the posterior communicating arteries (PCoAs) if an internal carotid artery (ICA) is occluded. Occlusions of the VAs proved to be far less critical than occlusions of the ICAs. The worst scenario in terms of reduction in the mean cerebral outflows is a CoW without the first segment of an anterior cerebral artery combined with an occlusion of the contralateral ICA. Furthermore, in patients without any severe occlusion of a carotid or VA, the direction of flow measured at the communicating arteries corresponds to the side of the CoW with an absent or occluded artery. Finally, we study the effect of partial occlusions of the communicating arteries on the cerebral flows, which again confirms that the ACoA is a more important collateral pathway than the PCoAs if an ICA is occluded.

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Author and article information

Contributors

Igor Sazonov:

ORCID: http://orcid.org/0000-0001-6685-2351

+44-1792-602767 , +44-1792 295676 , i.sazonov@swansea.ac.uk

Ashraf W. Khir: Ashraf.Khir@brunel.ac.uk

Wisam S. Hacham: wisam@kecbu.uobaghdad.edu.iq

Journal

Journal ID (nlm-ta): Biomech Model Mechanobiol

Journal ID (iso-abbrev): Biomech Model Mechanobiol

Title: Biomechanics and Modeling in Mechanobiology

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 1617-7959

ISSN (Electronic): 1617-7940

Publication date (Electronic): 21 February 2017

Publication date PMC-release: 21 February 2017

Publication date (Print): 2017

Volume: 16

Issue: 4

Pages: 1225-1242

Affiliations

[1 ]ISNI 0000 0001 0658 8800, GRID grid.4827.9, College of Engineering, , Swansea University, ; Bay Campus, Fabian Way, Swansea, SA1 8EN UK

[2 ]ISNI 0000 0001 0724 6933, GRID grid.7728.a, , Brunel University London, ; Uxbridge, London, B8 3PH UK

[3 ]ISNI 0000 0001 2108 8169, GRID grid.411498.1, Al-Khwarizmi College of Engineering, , Baghdad University, ; Baghdad, Iraq

[4 ]ISNI 0000 0004 0649 0266, GRID grid.416122.2, , Department of Vascular Surgery ABMUHB, Morriston Hospital, ; Swansea, SA6 6NL UK

Author information

Igor Sazonov http://orcid.org/0000-0001-6685-2351

Article

Publisher ID: 884

DOI: 10.1007/s10237-017-0884-8

PMC ID: 5511604

PubMed ID: 28220320

SO-VID: ff34e539-4d40-4c3f-8d52-9962f30d8571

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 13 June 2016

Date accepted : 1 February 2017

Funding

Funded by: A4B

Award ID: HE09151024

Award Recipient : Igor Sazonov

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ScienceOpen disciplines: Biophysics

Keywords: aneurysm detection,experimental models,numerical models,one-dimensional modelling,systemic circulation,waveforms

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ScienceOpen disciplines: Biophysics

Keywords: aneurysm detection, experimental models, numerical models, one-dimensional modelling, systemic circulation, waveforms

A novel method for non-invasively detecting the severity and location of aortic aneurysms

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Abstract

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Most cited references 35

The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial.

Computer simulation of arterial flow with applications to arterial and aortic stenoses.

Modelling the circle of Willis to assess the effects of anatomical variations and occlusions on cerebral flows.

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