Key result
Replacing the patient-specific inlet geometry with a parametric one caused significant differences in AAA hemodynamics (median differences 7.5-18.8%), whereas replacing the bifurcation geometry resulted in median differences below 1%.
Why the study?
3D+t ultrasound is preferred for longitudinal AAA hemodynamic studies but has a limited field-of-view that often fails to capture the inlet and aorto-iliac bifurcation geometry.
While it is not feasible to replace patient-specific inlet geometries with generic ones due to significant hemodynamic effects, parametric bifurcation geometries can be accurately used in AAA fluid-structure interaction simulations.
Answers are grounded in this paper and cite their sources.
Parametric inlet geometries risk inaccurate AAA hemodynamics; supports bifurcation simplification but leaves open validation in diverse cohorts.
To improve abdominal aortic aneurysm (AAA) rupture risk assessment, a large, longitudinal study on AAA hemodynamics and biomechanics is necessary, using personalized fluid-structure interaction (FSI) modeling. 3-dimensional, time-resolved ultrasound (3D+t US) is the preferred image modality to obtain the patient-specific AAA geometry for such a study, since it is safe, affordable and provides temporal information. However, the 3D+t US field-of-view (FOV) is limited and therefore often fails to capture the inlet and aorto-iliac bifurcation geometry. In this study, a framework was developed to add parametric inlet and bifurcation geometries to the abdominal aortic aneurysm geometry by employing dataset statistics and parameters of the AAA geometry. The impact of replacing the patient-specific inlet and bifurcation geometries, acquired using computed tomography (CT) scans, by parametric geometries was evaluated by examining the differences in hemodynamics (systolic and time-averaged wall shear stress and oscillatory shear index) in the aneurysm region. The results show that the inlet geometry has a larger effect on the AAA hemodynamics (median differences of 7.5 to 18.8%) than the bifurcation geometry (median differences all below 1%). Therefore, it is not feasible to replace the patient-specific inlet geometry by a generic one. Future studies should investigate the possibilities of extending the proximal FOV of 3D+t US. However, this study did show the feasibility of adding a parametric bifurcation geometry to the aneurysm geometry. After extending the proximal FOV, the obtained framework can be used to extract AAA geometries from 3D+t US for FSI simulations, despite the absence of the bifurcation geometry.
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Fonken et al. (2023) studied Abdominal Aortic Aneurysm (n=16). Parametric inlet and bifurcation geometries vs. Patient-specific CT-derived geometries was evaluated on Differences in hemodynamics (systolic and time-averaged wall shear stress and oscillatory shear index) in the aneurysm region. Replacing the patient-specific inlet geometry with a parametric one caused significant differences in AAA hemodynamics (median differences 7.5-18.8%), whereas replacing the bifurcation geometry resulted in median differences below 1%.
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