Hemodynamic Alterations Associated with Varying Aneurysm Sizes in the Aortic Arch

Aortic arch aneurysms are uncommon but clinically significant due to their rapid growth and increasing rupture risk. Analyzing flow changes associated with aneurysm enlargement is essential for understanding mechanisms of disease progression. However, computational studies focusing on the aortic arch aneurysm remain limited. In this study, computational fluid dynamics (CFD) simulations were conducted under pulsatile flow conditions to investigate flow characteristics across different aneurysm sizes. A patient-specific aortic geometry was reconstructed and modified to generate three idealized aneurysm models with diameters of 45, 55, and 65 mm, along with a healthy reference model. Key hemodynamic parameters, including velocity distribution, flow recirculation, wall shear stress (WSS), oscillatory shear index (OSI) and helicity, were analyzed. The results demonstrated that increasing aneurysm size significantly disrupts normal flow patterns, leading to reduced flow velocities and progressively enhanced recirculation zones, particularly during the deceleration phase of the cardiac cycle. Enlarged aneurysms also exhibited consistently low WSS, elevated OSI, and disrupted helical flow patterns along the vessel walls. These adverse hemodynamic conditions are associated with intraluminal thrombus (ILT) formation, localized wall thinning, and increased risk of dissection or rupture. Overall, this study highlights the critical role of aneurysm size in shaping aortic arch hemodynamics and provides a computational framework for assessing disease progression and rupture potential.