Multi-component model of intramural hematoma

Abstract

A novel multi-component model is introduced for studying interaction between blood flow and deforming aortic wall with intramural hematoma (IMH). The aortic wall is simulated by a composite structure submodel representing material properties of the three main wall layers. The IMH is described by a poroelasticity submodel which takes into account both the pressure inside hematoma and its deformation. The submodel of the hematoma is fully coupled with the aortic submodel as well as with the submodel of the pulsatile blood flow. Model simulations are used to investigate the relation between the peak wall stress, hematoma thickness and permeability in patients of different age. The results indicate that an increase in hematoma thickness leads to larger wall stress, which is in agreement with clinical data. Further simulations demonstrate that a hematoma with smaller permeability results in larger wall stress, suggesting that blood coagulation in hematoma might increase its mechanical stability. This is in agreement with previous experimental observations of coagulation having a beneficial effect on the condition of a patient with the IMH.

Demystifying penetrating atherosclerotic ulcer of aorta: unrealised tyrant of senile aortic changes

“…4 Typically, aortic diameter progresses by 1-2 mm per year, along with a synchronous increase in wall thickness and stiffness. 25 The demarcation point between IMH and PAU is the lack of entry point between the media and intima, as seen in the former's case. 9 Recently IMH is seen as a small thrombosed tear in the aortic intima precluding their visualization by imaging techniques.…”

“…37 The presence of IMH significantly elevates stress on aortic media, considerably increasing the likelihood of frank dissection or rupture. 25 In another scenario, IMH may involve and cause rupture of the origin of adjacent intercostal, lumbar, or bronchial arteries leading to the formation of intramural blood pool (IBP). They represent intramural hematoma communicating with side branch entry point via a narrow orifice.…”

A Novel Understanding of Phocidae Hearing Adaptations Through a Study of Northern Elephant Seal (Mirounga angustirostris) Ear Anatomy and Histology

“…The blood density was and viscosity was μ = 0.0035 Pa s (Bukac and Alber, ). Material properties of bones and joints in the middle ear was given by (Yao et al ., ).…”

Hematoma intramural e úlcera penetrante da aorta: incertezas e controvérsias

“…[24][25][26] In the specific case of IMH, it has been demonstrated experimentally that peak stress on the tunica media (peak wall stress) is much greater than is observed in an artery without hematoma, which might explain progression to rupture in the direction of the lumen or frank dissection. 27…”

“…In this case, the tunica media is subjected to very high stress, which has been demonstrated experimentally. 27 Since the IMH develops in the more external portions of the media, it can progress with rupture of the origin of intercostal arteries, causing retrograde flow to the wall thus creating blood pools that are detected at the external surface of the hematoma. Blood pools can also be created by small intimal ruptures, appearing now in the internal surface of the hematoma.…”