Image-Based Numerical Investigation in an Impending Abdominal Aneurysm Rupture

Blood flow dynamics plays a crucial role in the growth and rupture of abdominal aortic aneurysms. The aim of this study was to analyze the possibility of predicting aneurysmal rupture by numerical investigations based on diagnostic images. The blood flow dynamics was analyzed in a patient-specific abdominal aortic aneurysm, reconstructed from CT images of an aneurysm while it was rupturing. The patient-specific geometry was virtually repaired in order to obtain a non-ruptured model representative of the geometry immediately preceding the rupture. To reproduce physiological conditions, numerical simulations were performed under pulsatile flow conditions, and blood was modelled as a non-Newtonian fluid, using the Carreau rheological model. Hemodynamic parameters that influence the rupture of the aneurysm were investigated, and their possible association with vascular disease was discussed. The results of the numerical simulations indicated regions of slow recirculation and low values of Time Averaged Wall Shear Stress (TAWSS) in the region of rupture. Unlike literature results, a high Oscillatory Shear Index (OSI) was not clearly found in this region. Nevertheless, just in the region where the rupture will occur, high values of Endothelial Cell Activation Potential index (ECAP) were found. This index is therefore extremely significant for assessing the vulnerability of the aortic wall and locating the critical rupture region.