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

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.

[1]  Pedro A. Lemos,et al.  An Anatomically Detailed Arterial Network Model for One-Dimensional Computational Hemodynamics , 2015, IEEE Transactions on Biomedical Engineering.

[2]  L. Lupattelli,et al.  [The magnetic resonance imaging of abdominal aortic aneurysms]. , 1994, La Radiologia medica.

[3]  Pablo J. Blanco,et al.  Multidimensional modelling for the carotid artery blood flow , 2006 .

[4]  S. Sherwin,et al.  Modelling the circle of Willis to assess the effects of anatomical variations and occlusions on cerebral flows. , 2007, Journal of biomechanics.

[5]  K. Parker,et al.  Forward and backward running waves in the arteries: analysis using the method of characteristics. , 1990, Journal of biomechanical engineering.

[6]  Charles A. Taylor,et al.  Fractal network model for simulating abdominal and lower extremity blood flow during resting and exercise conditions , 2007, Computer methods in biomechanics and biomedical engineering.

[7]  Lieve Lanoye,et al.  Effect of an Abdominal Aortic Aneurysm on Wave Reflection in the Aorta , 2008, IEEE Transactions on Biomedical Engineering.

[8]  G. Meier,et al.  Is ultrasound more accurate than axial computed tomography for determination of maximal abdominal aortic aneurysm diameter? , 2004, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[9]  K Low,et al.  An improved baseline model for a human arterial network to study the impact of aneurysms on pressure‐flow waveforms , 2012, International journal for numerical methods in biomedical engineering.

[10]  J. Sloan,et al.  Ultrasound by emergency physicians to detect abdominal aortic aneurysms: a UK case series , 2004, Emergency Medicine Journal.

[11]  Lucas O. Müller,et al.  A benchmark study of numerical schemes for one‐dimensional arterial blood flow modelling , 2015, International journal for numerical methods in biomedical engineering.

[12]  N. Day,et al.  Accuracy of serial screening for abdominal aortic aneurysms by ultrasound , 2002, Journal of medical screening.

[13]  Pablo J. Blanco,et al.  Mathematical Model of Blood Flow in an Anatomically Detailed Arterial Network of the Arm , 2013 .

[14]  William R. Lees,et al.  Measurement of Aortic Compliance in Abdominal Aortic Aneurysms before and after Open and Endoluminal Repair: Preliminary Results , 2004, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[15]  Colin Berry,et al.  MRI using ultrasmall superparamagnetic particles of iron oxide in patients under surveillance for abdominal aortic aneurysms to predict rupture or surgical repair: MRI for abdominal aortic aneurysms to predict rupture or surgery—the MA3RS study , 2015, Open Heart.

[16]  Alfio Quarteroni,et al.  Multiscale modelling of the circulatory system: a preliminary analysis , 1999 .

[17]  P. Nithiarasu,et al.  A 1D arterial blood flow model incorporating ventricular pressure, aortic valve and regional coronary flow using the locally conservative Galerkin (LCG) method , 2008 .

[18]  W. P. Timlake,et al.  A theory of fluid flow in compliant tubes. , 1966, Biophysical journal.

[19]  A. Z. Barkin,et al.  Ultrasound detection of abdominal aortic aneurysm. , 2004, Emergency medicine clinics of North America.

[20]  Philip L. Johnson,et al.  Imaging of abdominal aortic aneurysms. , 2002, American family physician.

[21]  Alun D. Hughes,et al.  Forward and backward waves in the arterial system: impedance or wave intensity analysis? , 2009, Medical & Biological Engineering & Computing.

[22]  P J Blanco,et al.  On the integration of the baroreflex control mechanism in a heterogeneous model of the cardiovascular system , 2012, International journal for numerical methods in biomedical engineering.

[23]  Richard D. White,et al.  Quantification of abdominal aortic aneurysm stiffness using magnetic resonance elastography and its comparison to aneurysm diameter. , 2016, Journal of vascular surgery.

[24]  Spencer J. Sherwin,et al.  COMPUTATIONAL MODELLING OF 1D BLOOD FLOW AND ITS APPLICATIONS. , 2002 .

[25]  A. Quarteroni,et al.  One-dimensional models for blood flow in arteries , 2003 .

[26]  RAP Scott,et al.  The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial , 2002, The Lancet.

[27]  A. Avolio,et al.  Multi-branched model of the human arterial system , 1980, Medical and Biological Engineering and Computing.

[28]  Lucas O. Müller,et al.  Well‐balanced high‐order solver for blood flow in networks of vessels with variable properties , 2013, International journal for numerical methods in biomedical engineering.

[29]  K. Parker,et al.  Wave propagation in a model of the arterial circulation. , 2004, Journal of biomechanics.

[30]  Evelyn P Whitlock,et al.  Screening for Abdominal Aortic Aneurysm: A Best-Evidence Systematic Review for the U.S. Preventive Services Task Force , 2005, Annals of Internal Medicine.

[31]  D. Nelson,et al.  The accuracy of physical examination to detect abdominal aortic aneurysm. , 2000, Archives of internal medicine.

[32]  A. Quarteroni,et al.  On the coupling of 3D and 1D Navier-Stokes equations for flow problems in compliant vessels , 2001 .

[33]  Vassilios Raptopoulos,et al.  CT and MRI in diseases of the aorta. , 2009, AJR. American journal of roentgenology.

[34]  Gianluigi Rozza,et al.  Simulation‐based uncertainty quantification of human arterial network hemodynamics , 2013, International journal for numerical methods in biomedical engineering.

[35]  P G Huang,et al.  Simulation of one‐dimensional blood flow in networks of human vessels using a novel TVD scheme , 2015, International journal for numerical methods in biomedical engineering.

[36]  O. Catalano,et al.  Ruptured Abdominal Aortic Aneurysm , 2005, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[37]  Thomas J. R. Hughes,et al.  On the one-dimensional theory of blood flow in the larger vessels , 1973 .

[38]  Lucas O Müller,et al.  A global multiscale mathematical model for the human circulation with emphasis on the venous system , 2014, International journal for numerical methods in biomedical engineering.

[39]  D. F. Young,et al.  Computer simulation of arterial flow with applications to arterial and aortic stenoses. , 1992, Journal of biomechanics.

[40]  Spencer J. Sherwin,et al.  Computational modelling of 1D blood flow with variable mechanical properties and its application to the simulation of wave propagation in the human arterial system , 2003 .

[41]  T. Dahl,et al.  Ultrasound in Abdominal Aortic Aneurysm , 2011 .

[42]  K. Parker,et al.  Determination of wave speed and wave separation in the arteries. , 2001, Journal of biomechanics.

[43]  Alfio Quarteroni,et al.  A One Dimensional Model for Blood Flow: Application to Vascular Prosthesis , 2002 .

[44]  S. Sherwin,et al.  One-dimensional modelling of a vascular network in space-time variables , 2003 .