Computational Fluid Dynamics and Solid Mechanics Analyses of a Patient-Specific AAA Pre- and Post-EVAR

The establishment of a new pathway for blood flow immediately following endovascular aneurysm repair (EVAR) results in morphological changes and remodeling of the aneurismal sac. While EVAR is a minimally invasive surgical intervention, failure of the endovascular graft (EVG) may occur in which there is downstream migration and endoleak formation, creating a repressurization of the aneurismal sac and an increased risk of rupture. While the mechanism of aneurysm rupture and EVG failure is fundamental in nature, the factors that most significantly contribute to the end result are not yet fully understood. Mechanically, both are the consequence of an exerted force or disturbance exceeding the strength of a given material, whether it is the aneurismal arterial wall or the interaction that exists between the graft and wall. Embedded within this causal relationship are the contributions of arterial wall remodeling, intraluminal thrombus formation, and the dynamics that exists within the lumen. Several studies have been performed to examine these factors individually as they affect shear stress, the development of vortices, and the mechanical stress experienced along the arterial wall. However, a complete investigation is needed to study an anatomically realistic geometry operating under physiological conditions. The computational analyses conducted in this investigation address the confluence of these factors as they are modeled within an accurate patient-specific abdominal aortic aneurysm (AAA) reconstructed from CT scan data prior to and after EVAR. Our results verify the pressure-dominated characteristic of the flow and the negligible contribution of the dynamic and frictional force components; both are in good agreement with previously published results for analytical estimation of flow-induced forces in EVGs. [1]