İnfrarenal Akış Dalga Formunun Abdominal Aort Anevrizmalarının Hemodinamiği ve Reoloji Modellerinin Seçimi Üzerindeki Etkisi

Year 2025, Volume: 45 Issue: 1, 22 - 35, 07.04.2025

Burcu Ramazanlı , Cüneyt Sert , M. Metin Yavuz

https://doi.org/10.47480/isibted.1499633

Abstract

İnfrarenal akış dalga formu (IFW), farklı kardiyak koşullara yanıt olarak belirgin desenler sergilemekte olup, Newtonyen modelin uygulanabilirliği konusunda, farklı IFW paternleri arasında kayma hızı (|γ̇|) dağılımındaki değişiklikler nedeniyle soru işaretleri doğurmaktadır. Bu çalışma, Abdominal Aort Anevrizması (AAA) modeli içinde farklı IFW paternleri tarafından oluşturulan hemodinamik koşulları ve çeşitli reolojik modellerin tahminlerine olan etkilerini araştırmayı amaçlamaktadır. Sayısal simülasyonlar, basitleştirilmiş, eksen simetrik AAA geometrisi kullanılarak gerçekleştirilmiştir. Değişen tepe sistolik, diyastolik ve ortalama akış hızlarına sahip üç IFW paterni, Newtonyen, birkaç vizkoz kayma-incelmesi modeli ve viskoelastik (Oldroyd-B) modellerine uygulanmıştır. Hemodinamik koşullar, zaman ortalamalı duvar kayma gerilimi (TAWSS), osilatuar kayma indeksi (OSI), endotelyal hücre aktivasyon potansiyeli (ECAP) gibi önemli duvar kayma gerilimi (WSS) tanımlayıcıları ile |γ̇| dağılımları ve girdap paternlerinin evrimi izlenerek karşılaştırılmıştır. Sonuçlar, küçük IFW değişikliklerinin bile girdap taşıma mekanizmasını (VTM) önemli ölçüde etkilediğini göstermektedir. Anevrizma içinde proksimalden distal bölgelere doğru girdapların taşıma süresi, ortalama akış hızındaki artışla birlikte %50'ye kadar azalabilir. VTM'deki bu değişiklikler, |γ̇| dağılımını etkileyerek reolojik modellerin tahminlerinde önemli değişikliklere yol açar. Yüksek ortalama akış hızlarında bile Newtonyen model, Carreau ve Power modellerinin tahmin ettiğinden iki kat daha büyük bir OSI_(max) ve beş kat daha büyük bir ECAP_(max) öngörmektedir. Bununla birlikte, Oldroyd-B modelinin elde ettiği farklar, viskoz kayma-incelmesi gösteren modellerle karşılaştırıldığında nispeten daha küçüktür. Bu nedenle, Newtonyen model, yüksek ortalama akış hızlarıyla karakterize edilen durumlarda bile AAA simülasyonları için uygun değildir. Carreau ve Power modellerinin, hasta özelindeki sabitlerle entegre edilerek kullanılması, daha doğru hemodinamik tahminler sağlamada potansiyel taşıyabilir. Ayrıca, |γ̇| ile birlikte, reolojik model seçimi öncesinde IFW paterni ve buna bağlı VTM'nin kapsamlı bir değerlendirilmesi kritik ve önerilmektedir.

Keywords

Abdominal aort anevrizması hemodinamiği, Duvar kayma gerilimi (WSS) tanımlayıcıları, Girdap taşınımı, Döngüsel kuvvet, Kan reolojisi, Oldroyd-B modeli, OpenFOAM

Effect of Infrarenal Flow Waveform on Hemodynamics of Abdominal Aortic Aneurysms and Selection of Rheology Models

Abstract

The infrarenal flow waveform (IFW) demonstrates distinct patterns in response to varying cardiac conditions, raising questions regarding the applicability of the Newtonian model due to variations of the shear rate (|γ ̇ |) distribution across different IFW patterns. This study aims to investigate the hemodynamic conditions generated by different IFW patterns within an Abdominal Aortic Aneurysm (AAA) model, and their impact on the predictions of various rheological models. Numerical simulations are conducted using a simplified, axisymmetric AAA geometry. Three IFW patterns, with varying peak systolic, diastolic, and mean flow rates are applied to the Newtonian, several shear-thinning and viscoelastic (Oldroyd-B) models. The hemodynamic conditions are compared by monitoring important wall shear stress (WSS) descriptors including time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), endothelial cell activation potential (ECAP); with |γ ̇ | distributions and the evolution of vortex patterns. The results demonstrate that even small changes of IFW influence the vortex transport mechanism (VTM) considerably. The transportation time of the vortices from proximal to distal regions within the bulge decreases by up to 50% with an increase in the mean flow rate. These alterations in the VTM affect |γ ̇ | distribution, causing significant variations in the predictions of the rheological models. Even at high mean flow rates, the Newtonian predicts an OSI_(max ) twice as large as that predicted by the Carreau and Power models, along with an ECAP_(max ) that is 5 times greater. However, the differences obtained by the Oldroyd-B model are relatively minor when compared to the viscous shear-thinning models. Therefore, the Newtonian model is not appropriate for the AAA simulations, even in cases characterized by high mean flow rates. Employing the Carreau and Power models, by integrating the patient-specific constants, might exhibit a potential in providing more accurate hemodynamic predictions. Moreover, together with |γ ̇ |, a comprehensive assessment of IFW pattern and resulting VTM prior to the rheological model selection is critical and recommended.

Keywords

Abdominal aortic aneurysm hemodynamics, wall shear stress (WSS) descriptors, vortex transport, swirling strength, blood rheology, Oldroyd-B model, OpenFOAM

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