Patient based Abdominal Aortic Aneurysm rupture risk prediction combining clinical visualizing modalities with fluid structure interaction numerical simulations

Fluid structure interaction (FSI) simulations of patient-specific fusiform non-ruptured and contained ruptured Abdominal Aortic Aneurysm (AAA) geometries were conducted. The goals were: (1) to test the ability of our FSI methodology to predict the location of rupture, by correlating the high wall stress regions with the rupture location, (2) estimate the state of the pathological condition by calculating the ruptured potential index (RPI) of the AAA and (3) predict the disease progression by comparing healthy and pathological aortas. The patient specific AAA FSI simulations were carried out with advanced constitutive material models of the various components of AAA, including models that describe wall anisotropy based on collagen fibers orientation within the arterial wall, structural strength of the aorta, intraluminal thrombus (ILT), and embedded calcifications. The anisotropic material model used to describe the wall properties closely correlated with experimental results of AAA specimens. The results demonstrate that the anisotropic wall simulations showed higher peak wall stresses as compared to isotropic material models, indicating that the latter may underestimate the AAA risk of rupture. The ILT appeared to provide a cushioning effect reducing the stresses, while small calcifications (small-Ca) appeared to weaken the wall and contribute to the rupture risk. FSI simulations with ruptured AAA demonstrated that the location of the maximal wall stresses and RPI overlap the actual rupture region.