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2011 Meyer Bertrand Boiron Deplano Stereoscopically Observed Deformations Compliant Abdominal Aortic Aneurysm Model
2011 Meyer Bertrand Boiron Deplano Stereoscopically Observed Deformations Compliant Abdominal Aortic Aneurysm Model
2011 Meyer Bertrand Boiron Deplano Stereoscopically Observed Deformations Compliant Abdominal Aortic Aneurysm Model
Deformations of a Compliant
Abdominal Aortic Aneurysm
Model
Clark A. Meyer
Eric Bertrand
Olivier Boiron1
Valerie Deplano2
e-mail: deplano@irphe.univ-mrs.fr
Equipe de Biomecanique,
Institut de Recherche sur les Phenome`nes Hors
Equilibre (IRPHE) UMR 6594,
Centre National de la Recherche
Scientifique (CNRS),
13384 Marseille, France
A new experimental setup has been implemented to precisely measure the deformations
of an entire model abdominal aortic aneurysm (AAA). This setup addresses a gap
between the computational and experimental models of AAA that have aimed at improving the limited understanding of aneurysm development and rupture. The experimental
validation of the deformations from computational approaches has been limited by a lack
of consideration of the large and varied deformations that AAAs undergo in response to
physiologic flow and pressure. To address the issue of experimentally validating these
calculated deformations, a stereoscopic imaging system utilizing two cameras was constructed to measure model aneurysm displacement in response to pressurization. The
three model shapes, consisting of a healthy aorta, an AAA with bifurcation, and an AAA
without bifurcation, were also evaluated with computational solid mechanical modeling
using finite elements to assess the impact of differences between material properties and
for comparison against the experimental inflations. The device demonstrated adequate
accuracy (surface points were located to within 0.07 mm) for capturing local variation
while allowing the full length of the aneurysm sac to be observed at once. The experimental model AAA demonstrated realistic aneurysm behavior by having cyclic strains consistent with reported clinical observations between pressures 80 and 120 mm Hg. These
strains are 12%, and the local spatial variations in experimental strain were less than
predicted by the computational models. The three different models demonstrated that the
asymmetric bifurcation creates displacement differences but not cyclic strain differences
within the aneurysm sac. The technique and device captured regional variations of strain
that are unobservable with diameter measures alone. It also allowed the calculation of
local strain and removed rigid body motion effects on the strain calculation. The results
of the computations show that an asymmetric aortic bifurcation created displacement
differences but not cyclic strain differences within the aneurysm sac.
[DOI: 10.1115/1.4005416]
Keywords: abdominal aortic aneurysm, stereo correlation, compliant models, experimental deformations
Introduction
C 2011 by ASME
Copyright V
Methods
2.1 Geometry. Three representative shapes: AAA with bifurcation (AB), AAA without bifurcation (AU), and healthy bifurcated aorta (HB), are shown in Fig. 1. The geometry is the same
as that used by Deplano et al. [20]. Briefly, the AAAs bounding
curves in each plane are based upon exponentials of the form of
Eq. (1) with coefficients in Table 1, making the AAA sac asymmetric in the anterior-posterior (A-P) plane but otherwise symmetric. The geometry of the bifurcation is asymmetric in its
branching angle (take off angles of 29 and 18 for the right and
left common iliacs, respectively) and based upon patient M11
from Shah et al. [22]. Surfaces constructed from this geometric information provided the foundation of a computer aided design
(CAD) model.
!P1
2
C1 P2 xc2
e
(1)
coordinate Di p
pC3
At the maximum diameter location of the AAA sac in the CAD
model, the lateral width is 64.8 mm and the anterior-posterior
111004-2 / Vol. 133, NOVEMBER 2011
Di
C1
C2
C3
P1
P2
10.2
10
9.7
10.5
10.4
100
100
100
100
100
7
10
8
9
8
0.8
0.8
0.8
0.8
0.8
0.009
0.007
0.0095
0.006
0.008
0.85
0.75
0.95
0.81
0.39
distance is 54.6 mm. The proximal neck and healthy aorta are
21.6 mm in diameter. The overall length is 540 mm for each
model, and the AAA sac dimensions are the same in both models
with aneurysm (AB and AU).
2.2 Manufacture of Experimental Models. CAD models
were utilized for the machining of metal plates that were used by
a glassblower to make seamless glass molds. The AAA models
were constructed by repeatedly coating the glass molds interior
with polyurethane, as has been done previously for compliant
AAA models used for studying fluid flow patterns [20,23]. Briefly,
a mixture of EstaneV 5714 (1:10 by weight, of polymer to tetrahydrafurane) was made. The mixture was poured into a glass mold.
The mixture was drained out until dripping, and the mold was
loaded onto a dual-rotating platform inside a dryer, leaving a thin
layer adherent on the interior. The mold was dried for 30 min at
35 C. The coating process was repeated until there were six
layers, with the rotation directions alternated each time. The
model then finished curing overnight. A pilot study of polyurethane model shrinkage conducted on a uniform tube 25 mm in diameter indicated that, for the thickness of interest in these models
R
Fig. 2 Optical imaging setup with AB model and representative images from the device of the AU model with temporary
point markings
(2)
Psys Pdia
dsys ddia =ddia
(3)
Results
3.1 Material Testing. Evaluation of the stress-strain relationship for the molded polyurethane used in the experiment was
based upon uniaxial extension tests. Cyclic tests (10% strain at
1 Hz) showed an essentially linear behavior with a modulus of
17.5 MPa (1.75 107 Pa). This test is comparable to the loading
frequency when simulating flow, though the amplitude is exaggerated, as the minimum strain is not representative of that at diastolic pressure. A relaxation test was also conducted to assess
viscoelastic properties [35]. The relaxation test showed an 8%
decrease in the linearly estimated modulus when utilizing the
relaxed stress values instead of the peak values at each strain. The
relaxation period of 600 s was more than adequate for the stabilization of stress (not shown).
3.2 Calibration and Validation. The calibration of the measurement device provided a system capable of a sub-pixel level of
accuracy as demonstrated by a mean absolute 3D distance error of
0.0118 mm across all points, with a maximum error 0.108 mm.
The device accuracy was verified by quantifying the idealness of
positions resulting from a rotation ( 45 deg) of the calibration
plate. The mean position error was 0.07 mm, with a maximum
error of 0.18 mm. These levels of precision are adequate for
observing the expected motions of the sample while maintaining
the ability to view the full length of the AAA sac at once.
Further assessment of the system was done using HB shape for
a comparison between the LE computational model and the experimentally observed. The experimental HB case showed the uniform size reduction consistent with the pilot study and provides a
test case for the reconstruction technique. They differed by
< 0.05% in lateral and A-P peak distances at diastolic pressure in
the central region. The difference in peak cyclic strain was
< 0.35%, indicating the close match between LE and experiment
for this simple case.
3.3 Comparisons. Comparisons with differing materials
highlight the differences attributable to material models (between
columns of Figs. 35), and the consistency among the experiments
and computations expresses some of the limits in the validity in
the replacement of one type of model with another. Comparisons
between AU and AB shapes highlight the role of the bifurcation
(first two rows of Figs. 35), and comparisons between AB and
HB shapes highlight the role of the AAA sac (second and third
rows). The axial positions, shown in Fig. 3(b), illustrate that the
same region was compared in all cases. Within Table 2, the Ep
values of the different models are compared.
3.3.1 Effects of Material Model. The LE computational
model did not capture the full experimentally observed material
behavior of molded polyurethane when aneurysm was present.
Although a similarity in strain behavior and dimensions were noted
for the HB case, the AB and AU model types at diastolic pressure
are smaller in the A-P direction than the shapes observed with stereoscopic imaging. At diastolic pressure in the AU model, the A-P
maximum distances were 60.85 mm and 55.71 mm in the LE computational model and experiment, respectively. The lateral widths
are closer together, at 63.69 mm and 63.58 mm, respectively.
The differences between our LE computational model and
experiment are further manifest in the A-P component of motion,
as shown in Fig. 4(a), where the patterns as well as the magnitudes of motion are different. Specifically, the experiment showed
greater upward motion at the lateral portion above the midline. It
Transactions of the ASME
Fig. 4 Cyclic displacements in the (a) anterior-posterior direction, (b) axial direction, and (c) lateral direction. These cyclic
displacements are defined as the positions of nodes at 120 mm
Hg minus their position at 80 mm Hg. They are plotted on position observed at 80 mm Hg.
minimum cyclic strains are more similar with 0.014 (mm/mm) for
the LE and 0.015 for the R&V. The locations of these peak values
for maximum principal strain are consistent between LE and
R&V. The peak values occur in the lateral shoulders of the aneurysm shapes, where the diameter is tapering. The lowest strains
are observed after taper is complete in the LE models but at peak
sac diameter in the R&V model.
R&V with a thicker wall (2.0 mm versus 1.5 mm) is also considered because some computational models have used it, and
AAA wall thickness has been shown to vary over this range and
beyond [36]. Wall thickness has been shown to vary regionally
over an individual aneurysm, in addition to varying merely
between patients, and this is not accounted for in these models.
The effect of thickness is essentially uniform within each of the
measured parameters. The extreme positions at diastole in the AU
model with the 1.5 mm thickness are 64.2, 61.4, and 115.7 mm
apart in the lateral, A-P, and axial dimensions, respectively, and
63.6, 60.5, and 115.7 mm in the corresponding dimensions in the
NOVEMBER 2011, Vol. 133 / 111004-5
Fig. 5
Table 2 Ep values at the level of maximum diameter from computation and experiment, from average and planar dimensions
(Units of kPa)
Ep of AB models
Model type
LE
R&V 1.5 mm
R&V 2.0 mm
Experiment
Ep of AU models
Average
A-P
Lateral
Average
A-P
Lateral
274
365
421
328
178
280
294
227
369
450
548
460
276
366
427
341
177
277
293
323
354
432
522
360
2.0 mm thick model (Figs. 3(a), 3(b), and 3(c)). These reductions
indicate the 1.5 mm thick model is larger at diastolic pressure by
1.04% in the lateral direction and 1.44% in the A-P direction. The
axial dimension is consistent between models as the region is limited to the region visible with the stereoscopic system. Within the
AB models, the dimensions are almost exactly the same as the AU
except the lateral extremes are 0.03 mm closer together. Notably,
the thickness effect causes unequal changes in the A-P and lateral
directions as the aneurysm is asymmetric and not centered in the
A-P plane.
The effect of thickness difference with the R&V models is also
manifest in the response to systolic pressure. Using diastole as the
reference, the thinner model has greater motion in the lateral
direction in the AU and AB models by 10.08% (0.98 mm) AU and
12.09% (1.02 mm) AB. The A-P direction shows a more moderate
influence than the lateral, with motion difference values of 6.24%
AU and 5.41% AB on extreme ranges of 1.21 and 1.20 mm in the
1.5 mm thick models. These displacement differences are also
apparent in the results of Ep calculations, where using the average
of lateral and A-P diameters, the values are 3.65, 3.66, 4.21, and
4.27 105 Pa for the AB 1.5, AU 1.5, AB 2.0, and AU 2.0, respectively. Simplistically, a 25% reduction in thickness caused a 1314% reduction in Ep for R&V models with our idealized shapes.
The thickness effect on cyclic strain is nearly uniform (0.2%
strain). In absolute terms, thinner models had increases of cyclic
strains of 0.16% in both AAA outlet types. In relative terms, differences in cyclic strains of 8.96% in AB and 9.18% in AU were
found. For the same level of thickness decrease (25%), Venkatasubramaniam et al. [37] observed a 20% increase in stress. However, this value is not directly comparable, because that study
looked at the peak value and not the value relative to diastolic.
3.3.2 Geometric Effects. The bifurcation has often been
excluded in computational models of the AAA [6,38]. Consideration
111004-6 / Vol. 133, NOVEMBER 2011
Discussion
The rupture risk of an individual aneurysm is specific to a combination of factors (thickness, smoking, genetics, shape, etc.)
within each patient, though some factors, such as maximum diameter, typically dominate. To best treat a patient, an understanding
of their AAA as it currently is and as it is likely to become is necessary. Before a greater understanding of a patient specific case is
possible, there must be an understanding of the idealized case, and
this study provides insight into one of the most important aspects
(mechanical stress and motion) through both experimental and
computational methods.
The aneurysm shape used in this study attempted to strike a balance between some of the essential features of AAA and simplification. The shape is less symmetric than others [40,41],
particularly at the bifurcation, which allowed isolation of that features role. Increasing the complexity of AAA models provides
Transactions of the ASME
Conclusion
Acknowledgment
The authors would like to acknowledge the support of the Whitaker Scholars program for C. Meyer.
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