Key result
Decreasing aorto-iliac area ratio raises peak wall stress and SBP ~18%, indicating potential AAA risk.
Why the study?
Aorto-iliac bifurcation geometry may affect aortic pressure and wall stress, potentially serving as a predictor of abdominal aortic aneurysm.
Does the geometry of the aorto-iliac bifurcation affect pressure and wall stress in the abdominal aorta?
Does the geometry of the aorto-iliac bifurcation affect pressure and wall stress in the abdominal aorta?
Effect estimate: up to 18.4% and 18.8% increase
Lower area ratio of iliac to aortic luminal cross sections increases blood pressure and wall stress in the abdominal aorta, potentially serving as a risk factor for abdominal aortic aneurysm development.
• Idealised geometries of aorto-iliac tree on the basis of in-vivo measurements. • Fluid-structure interaction parametric analysis with changes in the bifurcation geometry. • Aorto-iliac angles do not influence the pressure and stress in abdominal aorta . • Aorto-iliac ratio increases the pressure and the risk of abdominal aortic aneurysm . Geometry of aorto-iliac bifurcation may affect pressure and wall stress in aorta and thus potentially serve as a predictor of abdominal aortic aneurysm (AAA), similarly to hypertension. Effect of aorto-iliac bifurcation geometry was investigated via parametric analysis based on two-way weakly coupled fluid-structure interaction simulations. The arterial wall was modelled as isotropic hyperelastic monolayer, and non-Newtonian behaviour was introduced for the fluid. Realistic boundary conditions of the pulsatile blood flow were used on the basis of experiments in literature and their time shift was tailored to the pulse wave velocity in the model to obtain physiological wave shapes. Eighteen idealized and one patient-specific geometries of human aortic tree with common iliac and renal arteries were considered with different angles between abdominal aorta (AA) and both iliac arteries and different area ratios (AR) of iliac and aortic luminal cross sections. Peak wall stress (PWS) and systolic blood pressure (SBP) were insensitive to the aorto-iliac angles but sensitive to the AR: when AR decreased by 50%, the PWS and SBP increased by up to 18.4% and 18.8%, respectively. Lower AR (as a result of the iliac stenosis or aging), rather than the aorto-iliac angles increases the BP in the AA and may be thus a risk factor for the AAA development.
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Jagoš et al. (2023) studied Abdominal aortic aneurysm risk (n=19). Decreased aorto-iliac area ratio vs. Higher area ratio was evaluated on Peak wall stress (PWS) and systolic blood pressure (SBP) (up to 18.4% and 18.8% increase). Decreasing the aorto-iliac area ratio by 50% increased peak wall stress and systolic blood pressure by up to 18.4% and 18.8%, respectively, indicating it may be a risk factor for AAA development.
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