Computational fluid dynamic analysis in infrarenal abdominal aortic aneurysm for surveillance of aneurysm potential rupture

Objective This study aims to identify the morphology of infrarenal abdominal aortic aneurysm and analyze wall shear stress and wall pressure using computational fluid dynamic analysis to predict potential rupture areas. Methods A cross-sectional study was conducted on infrarenal abdominal aortic aneurysm patients at the Vascular and Endovascular Division, Department of Surgery, and the Department of Radiology, RSUPN Dr. Cipto Mangunkusumo, from July to December 2022. Three-dimensional models were reconstructed from computed tomography angiograms and infrarenal abdominal aortic aneurysms were classified into five morphological types. Computational fluid dynamic analysis was performed to generate wall shear stress and wall pressure contours at varying blood pressure and velocity. Visual results for each type were analyzed and compared. Statistical analysis was conducted using SPSS 25.0. Results From 93 computed tomography angiograms, 40 samples met the inclusion criteria. Twenty-five percent of samples had a saccular component. Visual analysis showed a correlation between areas of lowest wall shear stress and highest wall pressure. Velocity and blood pressure also affected wall shear stress and wall pressure; however, the center of the contour as potential prediction rupture sites remained consistent. Significant differences were found in wall shear stress and wall pressure (p = 0.038 and p < 0.001). Conclusion Areas of lowest wall shear stress correspond with highest wall pressure, indicating potential rupture sites. Blood velocity and pressure changes also influenced wall shear stress and wall pressure. Surveillance should be subjected to closer inspection on areas with lowet wall shear stress.