We present the first mathematical model to account for the evolution of the abdominal aortic aneurysm. The artery is modelled as a two-layered, cylindrical membrane using nonlinear elasticity and a physiologically realistic constitutive model. It is subject to a constant systolic pressure and a physiological axial prestretch. The development of the aneurysm is assumed to be a consequence of the remodelling of its material constituents. Microstructural 'recruitment' and fibre density variables for the collagen are introduced into the strain energy density functions. This enables the remodelling of collagen to be addressed as the aneurysm enlarges. An axisymmetric aneurysm, with axisymmetric degradation of elastin and linear differential equations for the remodelling of the fibre variables, is simulated numerically. Using physiologically determined parameters to model the abdominal aorta and realistic remodelling rates for its constituents, the predicted dilations of the aneurysm are consistent with those observed in vivo. An asymmetric aneurysm with spinal contact is also modelled, and the stress distributions are consistent with previous studies.
The novel three-dimensional (3D) mathematical model for the development of abdominal aortic aneurysm (AAA) of Watton et al. Biomech Model Mechanobiol 3(2): 98-113, (2004) describes how changes in the micro-structure of the arterial wall lead to the development of AAA, during which collagen remodels to compensate for loss of elastin. In this paper, we examine the influence of several of the model's material and remodelling parameters on growth rates of the AAA and compare with clinical data. Furthermore, we calculate the dynamic properties of the AAA at different stages in its development and examine the evolution of clinically measurable mechanical properties. The model predicts that the maximum diameter of the aneurysm increases exponentially and that the ratio of systolic to diastolic diameter decreases from 1.13 to 1.02 as the aneurysm develops; these predictions are consistent with physiological observations of Vardulaki et al. Br J Surg 85:1674-1680 (1998) and Lanne et al. Eur J Vasc Surg 6:178-184 (1992), respectively. We conclude that mathematical models of aneurysm growth have the potential to be useful, noninvasive diagnostic tools and thus merit further development.
The physiological mechanisms that give rise to the inception and development of a cerebral aneurysm are accepted to involve the interplay between the local mechanical forces acting on the arterial wall and the biological processes occurring at the cellular level. In fact, the wall shear stresses (WSSs) that act on the endothelial cells are thought to play a pivotal role. A computational framework is proposed to explore the link between the evolution of a cerebral aneurysm and the influence of hemodynamic stimuli that act on the endothelial cells. An aneurysm evolution model, which utilizes a realistic microstructural model of the arterial wall, is combined with detailed 3D hemodynamic solutions. The evolution of the blood flow within the developing aneurysm determines the distributions of the WSS and the spatial WSS gradient (WSSG) that act on the endothelial cell layer of the tissue. Two illustrative examples are considered: Degradation of the elastinous constituents is driven by deviations of WSS or the WSSG from normotensive values. This model provides the basis to further explore the etiology of aneurysmal disease.
A fluid-solid-growth (FSG) model of saccular cerebral aneurysm evolution is developed. It utilises a realistic two-layered structural model of the internal carotid artery and explicitly accounts for the degradation of the elastinous constituents and growth and remodelling (G&R) of the collagen fabric. Aneurysm inception is prescribed: a localised degradation of elastin results in a perturbation in the arterial geometry; the collagen fabric adapts, and the artery achieves a new homeostatic configuration. The perturbation to the geometry creates an altered haemodynamic environment. Subsequent degradation of elastin is explicitly linked to low wall shear stress (WSS) in a confined region of the arterial domain. A sidewall saccular aneurysm develops, the collagen fabric adapts and the aneurysm stabilises in size. A quasi-static analysis is performed to determine the geometry at diastolic pressure. This enables the cyclic stretching of the tissue to be quantified, and we propose a novel index to quantify the degree of biaxial stretching of the tissue. Whilst growth is linked to low WSS from a steady (systolic) flow analysis, a pulsatile flow analysis is performed to compare steady and pulsatile flow parameters during evolution. This model illustrates the evolving mechanical environment for an idealised saccular cerebral aneurysm developing on a cylindrical parent artery and provides the guidance to more sophisticated FSG models of aneurysm evolution which link G&R to the local mechanical stimuli of vascular cells.
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