Real-Time Evaluation of Blood Flow Patterns Using AneurysmFlow for an in vivo Abdominal Aortic Aneurysm Model

Young Jun Park; Sang Kyun Mok; Sun Cheol Park; Sang Seob Yun; Jang Yong Kim

doi:10.1016/j.avsg.2021.08.044

Real-Time Evaluation of Blood Flow Patterns Using AneurysmFlow for an in vivo Abdominal Aortic Aneurysm Model

Ann Vasc Surg. 2022 Mar:80:256-263. doi: 10.1016/j.avsg.2021.08.044. Epub 2021 Nov 6.

Authors

Young Jun Park¹, Sang Kyun Mok¹, Sun Cheol Park¹, Sang Seob Yun¹, Jang Yong Kim²

Affiliations

¹ The Department of Vascular and Transplant Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
² The Department of Vascular and Transplant Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. Electronic address: inhags@gmail.com.

PMID: 34752852
DOI: 10.1016/j.avsg.2021.08.044

Abstract

Background: Many new tools for abdominal aortic aneurysm (AAA) rupture risk evaluation have been developed. These new tools need detailed hemodynamic information in AAA. However, hemodynamic data obtained from in vivo research are lacking. Thus, the objective of this study was to analyze blood flow patterns in an in vivo AAA model to acquire real-time hemodynamic information using AneurysmFlow, a novel flow evaluation system.

Methods: Digital subtraction angiography images of patients who underwent endovascular aneurysm repair were analyzed using the visualization function of the AneurysmFlow to classify blood flow patterns as laminar or turbulent flow. The presence of boundary layer separation was also evaluated. The time taken for contrast medium to travel from the infrarenal aortic neck to aortic bifurcation was acquired to calculate the flow velocity. Associations between characteristics of aneurysm including lumen occupying ratio of intraluminal thrombus (ILT) and the hemodynamic flow pattern were evaluated.

Results: A total of 37 AAA patients was enrolled. Their blood flow patterns were evaluated using the AneurysmFlow. Logistic regression analyses with lumen occupying ratio of ILT as an independent variable showed that the larger the lumen occupying ratio of ILT, the more likely the aneurysm was to show a laminar pattern (P = 0.03), and the more likely the boundary layer separation would not exist (P = 0.04). The flow velocity from the infrarenal aortic neck to the aortic bifurcation showed a positive association with the lumen occupying ratio of the ILT in linear regression analysis (P < 0.001).

Conclusions: Hemodynamic analysis of AAA with the AneurysmFlow using real-time individual patient models showed different flow patterns and flow velocities depending on ILT. This novel analytic approach using AneurysmFlow has potential to play an important role in obtaining clinically meaningful hemodynamic information of AAA.

Keywords: Abdominal aortic aneurysms; Angiography; Fusion imaging; Hemodynamics; Imaging.

MeSH terms

Aged
Aorta, Abdominal / physiology*
Aortic Aneurysm, Abdominal / physiopathology*
Female
Hemodynamics*
Humans
Male
Models, Cardiovascular*
Regional Blood Flow
Regression Analysis
Retrospective Studies