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A comparison of hemodynamic metrics and intraluminal thrombus burden in a common iliac artery aneurysm
Lachlan J Kelsey1,2, Janet T Powell3, Paul E Norman1,4
1Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, Perth, WA, Australia.
Insights
Isolated common iliac artery aneurysms (CIAAs) can develop intraluminal thrombus (ILT). Hemodynamic factors like cell residence time and wall shear stress correlate with ILT location, offering insights into aneurysm development.
Area of Science:
- Vascular Surgery
- Biomedical Engineering
- Cardiovascular Research
Background:
- Common iliac artery aneurysms (CIAAs) are often associated with abdominal aortic aneurysms (AAAs).
- Isolated CIAAs, without co-existing AAAs, are rare but can develop intraluminal thrombus (ILT).
- The contralateral iliac artery in isolated CIAA cases offers a unique comparison for studying ILT formation mechanisms.
Purpose of the Study:
- To investigate the correlation between hemodynamic metrics and intraluminal thrombus (ILT) development in isolated common iliac artery aneurysms (CIAAs).
- To utilize computational fluid dynamics (CFD) to analyze flow patterns and their relationship with thrombus burden.
Main Methods:
- A computational fluid dynamics (CFD) study comparing a large isolated CIAA with its contralateral iliac artery.
- Analysis of platelet and monocyte residence times, velocity fields, time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and endothelial cell activation potential.
- Correlation of CFD-derived hemodynamic data with ILT burden measured by computed tomography (CT).
Main Results:
- High cell residence times were observed in regions with ILT.
- Low time-averaged wall shear stress (TAWSS) and high oscillatory shear index (OSI) correlated with ILT development.
- Increased endothelial cell activation potential was associated with ILT presence.
- Hemodynamic findings align with existing hypotheses on thrombus formation in abdominal aortic aneurysms (AAAs).
Conclusions:
- Hemodynamic factors play a significant role in the localization of intraluminal thrombus within isolated common iliac artery aneurysms.
- Computational fluid dynamics is a valuable tool for understanding the biomechanics of iliac artery aneurysms.
- Findings contribute to the understanding of thrombus formation in vascular aneurysms.
Abstract:
Aneurysms of the common iliac artery (CIAA) are typically found in association with an abdominal aortic aneurysm (AAA). Isolated CIAAs, in the absence of an AAA, are uncommon. Similar to AAAs, CIAA may develop intraluminal thrombus (ILT). As isolated CIAAs have a contralateral common iliac artery for comparison, they provide an opportunity to study the hemodynamic mechanisms behind ILT formation. In this study, we compared a large isolated CIAA and the contralateral iliac artery using computational fluid dynamics to determine if hemodynamic metrics correlate with the location of ILT. We performed a comprehensive computational fluid dynamics study and investigated the residence time of platelets and monocytes, velocity fields, time-averaged wall shear stress, oscillatory shear index, and endothelial cell activation potential. We then correlated these data to ILT burden determined with computed tomography. We found that high cell residence times, low time-averaged wall shear stress, high oscillatory shear index, and high endothelial cell activation potential all correlate with regions of ILT development. Our results show agreement with previous hypotheses of thrombus formation in AAA and provide insights into the computational hemodynamics of iliac artery aneurysms.
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