title: Haemodynamic predictors of a penetrating atherosclerotic ulcer rupture using fluid-structure interaction analysis.
abstract: We present preliminary data on the flow-induced haemodynamic and structural loads exerted on a penetrating atherosclerotic aortic ulcer (PAU). Specifically, one-way fluid-structure interaction analysis was performed on the aortic model reconstructed from a 66-year-old male patient with a PAU that evolved into an intramural haematoma and rupture of the thoracic aorta. The results show that elevated blood pressure (117 mmHg) and low flow velocity at the aortic wall (0.15 m/s(2)) occurred in the region of the PAU. We also found a low value of time-averaged wall shear stress (1.24 N/m(2)) and a high value of the temporal oscillation in the wall shear stress (oscillatory shear index = 0.13) in the region of the PAU. After endovascular treatment, these haemodynamic parameters were distributed uniformly on the luminal surface of the stent graft. These findings suggest that wall shear stress could be considered one of the major haemodynamic factors indicating the structural fragility of the PAU wall, which ultimately lead to PAU growth and rupture.
authors.affiliation: Cardiothoracic Department, Mediterranean Institute for Transplantation and Advanced Medical Therapies (ISMETT), Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Ancona
authors.forename: Andrea
authors.initials: A
authors.lastname: Amaducci
authors.forename: Antonino
authors.initials: A
authors.lastname: Rinaudo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pasta
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Follis
authors.forename: Michele
authors.initials: M
authors.lastname: Pilato
authors.forename: Roberto
authors.initials: R
authors.lastname: Baglini
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001027:Aortography / Q000379:methods; D062186:Arterial Pressure; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001783:Blood Flow Velocity; D019917:Blood Vessel Prosthesis Implantation; D003198:Computer Simulation; D057510:Endovascular Procedures; D006406:Hematoma / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008955:Models, Cardiovascular; D012039:Regional Blood Flow; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery
keywords: Fluid–structure interaction; Penetrating atherosclerotic ulcer; Wall shear stress