Hemodynamics-driven deposition of intraluminal thrombus in abdominal aortic aneurysms

Int J Numer Method Biomed Eng. 2017 May;33(5):10.1002/cnm.2828. doi: 10.1002/cnm.2828. Epub 2016 Oct 7.

Abstract

Accumulating evidence suggests that intraluminal thrombus plays many roles in the natural history of abdominal aortic aneurysms. There is, therefore, a pressing need for computational models that can describe and predict the initiation and progression of thrombus in aneurysms. In this paper, we introduce a phenomenological metric for thrombus deposition potential and use hemodynamic simulations based on medical images from 6 patients to identify best-fit values of the 2 key model parameters. We then introduce a shape optimization method to predict the associated radial growth of the thrombus into the lumen based on the expectation that thrombus initiation will create a thrombogenic surface, which in turn will promote growth until increasing hemodynamically induced frictional forces prevent any further cell or protein deposition. Comparisons between predicted and actual intraluminal thrombus in the 6 patient-specific aneurysms suggest that this phenomenological description provides a good first estimate of thrombus deposition. We submit further that, because the biologically active region of the thrombus appears to be confined to a thin luminal layer, predictions of morphology alone may be sufficient to inform fluid-solid-growth models of aneurysmal growth and remodeling.

Keywords: aneurysm; computational fluid dynamics; optimization; shear stress; thrombus.

MeSH terms

  • Aortic Aneurysm, Abdominal / etiology
  • Aortic Aneurysm, Abdominal / pathology*
  • Disease Progression
  • Finite Element Analysis
  • Hemodynamics*
  • Humans
  • Models, Cardiovascular
  • Thrombosis / complications
  • Thrombosis / pathology*