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Journal ArticleDOI

The Effects of Geometric Features of Intraluminal Thrombus on the Vessel Wall Oxygen Deprivation

TL;DR: The hypothesis that the presence of ILT in AAA correlates to significantly impaired oxygen transport to the aneurysmal wall is supported and it is observed that ILT thickness and length are the parameters that influence decreased oxygen flow and concentration values the most, and thick thrombi exacerbate hypoxic conditions in the arterial wall, which may contribute to increased tissue degradation.
Abstract: The objective of this paper is to analyze the association of intraluminal thrombus (ILT) presence and morphology with oxygen transport in abdominal aortic aneurysms (AAA) and local hypoxia. The biomechanical role of the ILT layer in the evolution of the aneurysm is still not fully understood. ILT has been shown to create an inflammatory environment by reducing oxygen flux to the arterial wall and therefore decreasing its strength. It has been also hypothesized that the geometry of the ILT may further affect AAA rupture. However, no previous research has attempted to explore the effect of morphological features of ILT on oxygen distributions within the AAA, in a systematic manner. In this study, we perform a comprehensive analysis to investigate how physiologically meaningful variations in ILT geometric characteristics affect oxygen transport within an AAA. We simulate twenty-seven AAA models with variable ILT dimensions and investigate the extent to which ILT attenuates oxygen concentration in the arterial wall. Geometric variations studied include ILT thickness and ILT length, as well as the bulge diameter of the aneurysm which is related to ILT curvature. Computer simulations of coupled fluid flow-mass transport between arterial wall, ILT, and blood are solved and spatial variations of oxygen concentrations within the ILT and wall are obtained. The comparison of the results for all twenty-seven simulations supports the hypothesis that the presence of ILT in AAA correlates to significantly impaired oxygen transport to the aneurysmal wall. Mainly, we observed that ILT thickness and length are the parameters that influence decreased oxygen flow and concentration values the most, and thick thrombi exacerbate hypoxic conditions in the arterial wall, which may contribute to increased tissue degradation. Conversely, we observed that the arterial wall oxygen concentration is nearly independent of the AAA bulge diameter. This confirms that consideration of ILT size and anatomy is crucial in the analysis of AAA development.
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Journal ArticleDOI
TL;DR: Investigation of the biomechanical role of intraluminal thrombus in an abdominal aortic aneurysm finds that ILT decreases oxygen transport within the tissue significantly, leading to wall hypoxia.

5 citations

Journal ArticleDOI
24 Oct 2022-Oxygen
TL;DR: In this article , the authors investigated the effects of ILT structural composition on oxygen flow by adopting a multilayered porous framework and comparing a two-layer ILT model with one-layer models.
Abstract: Determination of abdominal aortic aneurysm (AAA) rupture risk involves the accurate prediction of mechanical stresses acting on the arterial tissue, as well as the wall strength which has a correlation with oxygen supply within the aneurysmal wall. Our laboratory has previously reported the significance of an intraluminal thrombus (ILT) presence and morphology on localized oxygen deprivation by assuming a uniform consistency of ILT. The aim of this work is to investigate the effects of ILT structural composition on oxygen flow by adopting a multilayered porous framework and comparing a two-layer ILT model with one-layer models. Three-dimensional idealized and patient-specific AAA geometries are generated. Numerical simulations of coupled fluid flow and oxygen transport between blood, arterial wall, and ILT are performed, and spatial variations of oxygen concentrations within the AAA are obtained. A parametric study is conducted, and ILT permeability and oxygen diffusivity parameters are individually varied within a physiological range. A gradient of permeability is also defined to represent the heterogenous structure of ILT. Results for oxygen measures as well as filtration velocities are obtained, and it is found that the presence of any ILT reduces and redistributes the concentrations in the aortic wall markedly. Moreover, it is found that the integration of a porous ILT significantly affects the oxygen transport in AAA and the concentrations are linked to ILT’s permeability values. Regardless of the ILT stratification, maximum variation in wall oxygen concentrations is higher in models with lower permeability, while the concentrations are not sensitive to the value of the diffusion coefficient. Based on the observations, we infer that average one-layer parameters for ILT material characteristics can be used to reasonably estimate the wall oxygen concentrations in aneurysm models.

1 citations

Journal ArticleDOI
TL;DR: In this paper , the effects of variations in the vocal fold morphological features associated with gender on glottal aerodynamics and tissue deformation were examined by incorporating the transient Navier-Stokes equations to model airflow through the larynx and considering a linear elasticity model for VF dynamics.
Abstract: This paper aims to examine the effects of variations in the vocal fold (VF) morphological features associated with gender on glottal aerodynamics and tissue deformation. Nine three-dimensional geometries of the VFs in the larynx are created with various VF lengths, thicknesses, and depths to perform a parametric analysis according to gender-related geometrical parameters. The computational model is incorporated in a fluid–structure interaction methodology by adopting the transient Navier–Stokes equations to model airflow through the larynx and considering a linear elasticity model for VF dynamics. The model predictions, such as aerodynamic data through the larynx, glottal airflow, and VF deformations, are analyzed. The comparison of the simulation results for the nine cases supports the hypothesis that gender differences in laryngeal dimensions remarkably influence the glottal airflow and deformation of the VFs. Decreasing VF thickness and increasing its length corresponds to a noticeable increase in maximum tissue displacement, while variations in depth affect the flow rate significantly in the small and large larynges. Conversely, we observed that the pressure drop at the glottis is nearly independent of the VF length. A comparison of the glottal area with published imaging data illustrated a direct correlation between the glottal configuration and the morphology of the VFs.
References
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Journal ArticleDOI
TL;DR: Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) A Collaborative Report from the American Association for Vascular Surgery/Society for V vascular surgery,* Society for Cardiovascular Angiography and Interventions, Society forVascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines.
Abstract: Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) A Collaborative Report from the American Association for Vascular Surgery/Society for Vascular Surgery,* Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease) Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation

3,239 citations

Journal ArticleDOI
TL;DR: The study of arterial blood flow will lead to the prediction of individual hemodynamic flows in any patient, the development of diagnostic tools to quantify disease, and the design of devices that mimic or alter blood flow.
Abstract: Blood flow in arteries is dominated by unsteady flow phenomena. The cardiovascular system is an internal flow loop with multiple branches in which a complex liquid circulates. A nondimensional frequency parameter, the Womersley number, governs the relationship between the unsteady and viscous forces. Normal arterial flow is laminar with secondary flows generated at curves and branches. The arteries are living organs that can adapt to and change with the varying hemodynamic conditions. In certain circumstances, unusual hemodynamic conditions create an abnormal biological response. Velocity profile skewing can create pockets in which the direction of the wall shear stress oscillates. Atherosclerotic disease tends to be localized in these sites and results in a narrowing of the artery lumen—a stenosis. The stenosis can cause turbulence and reduce flow by means of viscous head losses and flow choking. Very high shear stresses near the throat of the stenosis can activate platelets and thereby induce thrombosis, which can totally block blood flow to the heart or brain. Detection and quantification of stenosis serve as the basis for surgical intervention. In the future, the study of arterial blood flow will lead to the prediction of individual hemodynamic flows in any patient, the development of diagnostic tools to quantify disease, and the design of devices that mimic or alter blood flow. This field is rich with challenging problems in fluid mechanics involving three-dimensional, pulsatile flows at the edge of turbulence.

1,336 citations

Journal ArticleDOI
TL;DR: A Collaborative Report from the American Associations for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients with Peripheral Arterial Disease) makes recommendations on treatment of peripheral artery disease.

862 citations

Journal ArticleDOI
TL;DR: Procedures are described to determine Po2 and S of blood iteratively after extraction or addition of a defined amount of O2 and to compute P50 of blood from a single sample after measuring Po2, pH, and S.
Abstract: Hill's equation can be slightly modified to fit the standard human blood O2 dissociation curve to within plus or minus 0.0055 fractional saturation (S) from O less than S less than 1. Other modifications of Hill's equation may be used to compute Po2 (Torr) from S (Eq. 2), and the temperature coefficient of Po2 (Eq. 3). Variations of the Bohr coefficient with Po2 are given by Eq. 4. S = (((Po2(3) + 150 Po2)(-1) x 23,400) + 1)(-1) (1) In Po2 = 0.385 In (S-1 - 1)(-1) + 3.32 - (72 S)(-1) - 0.17(S6) (2) DELTA In Po2/delta T = 0.058 ((0.243 X Po2/100)(3.88) + 1)(-1) + 0.013 (3) delta In Po2/delta pH = (Po2/26.6)(0.184) - 2.2 (4) Procedures are described to determine Po2 and S of blood iteratively after extraction or addition of a defined amount of O2 and to compute P50 of blood from a single sample after measuring Po2, pH, and S.

691 citations

Journal ArticleDOI
TL;DR: The results suggest that localized hypoxia occurs in regions of thicker ILT in AAA, which may lead to increased, localized mural neovascularization and inflammation, as well as regional wall weakening.

456 citations