Online first
Research paper
Published online: 2024-12-06
Consequences of the presence of atherosclerotic lesions within the thoracic aorta during a car crash — a finite element method study
1
, 2, 34
, 2, 34
DOI: 10.5603/aa.99725
Abstract
Atherosclerosis has been shown to alter vascular properties and predispose to injury. Blunt aortic trauma (BAT)
is responsible for 20% of vehicle-related deaths. This work aims to demonstrate and better understand the
biomechanics of the aorta with and without atherosclerotic changes during a frontal car crash using a finite
element method (FEM). Secondarily, the influence of blood pressure was evaluated. A FEM model was created
with an ANSYS system based on computed tomography images of 44 patients.The distribution of stress and
deformation varies according to the stage of atherosclerotic disease. Finally, at a speed of 30 km/h, an aortic
rupture occurs. The presence of a calcified atherosclerotic plaque in the thoracic aorta at an advanced and
calcified stage increases its susceptibility to rupture during a car crash. No effect of blood pressure on aortic
biomechanics was observed.
Keywords: atherosclerosisaortabiomechanicscar crash
References
- Zhao AR, Field ML, Digges K, et al. Blunt trauma and acute aortic syndrome: a three-layer finite-element model of the aortic wall. Eur J Cardiothorac Surg. 2008; 34(3): 623–629.
- Siegel JH, Belwadi A, Smith JA, et al. Analysis of the mechanism of lateral impact aortic isthmus disruption in real-life motor vehicle crashes using a computer-based finite element numeric model: with simulation of prevention strategies. J Trauma. 2010; 68(6): 1375–1395.
- Mohamied Y, Rowland EM, Bailey EL, et al. Change of direction in the biomechanics of atherosclerosis. Ann Biomed Eng. 2015; 43(1): 16–25.
- Lacolley P, Regnault V, Avolio AP. Smooth muscle cell and arterial aging: basic and clinical aspects. Cardiovasc Res. 2018; 114(4): 513–528.
- Kozuń M, Kobielarz M, Chwiłkowska A, et al. The impact of development of atherosclerosis on delamination resistance of the thoracic aortic wall. J Mech Behav Biomed Mater. 2018; 79: 292–300.
- Holzapfel GA, Gasser TC, Ogden RW. Comparison of a multi-layer structural model for arterial walls with a fung-type model, and issues of material stability. J Biomech Eng. 2004; 126(2): 264–275.
- Kobielarz M, Kozuń M, Gąsior-Głogowska M, et al. Mechanical and structural properties of different types of human aortic atherosclerotic plaques. J Mech Behav Biomed Mater. 2020; 109: 103837.
- Erbel R, Aboyans V, Boileau C, et al. ESC Committee for Practice Guidelines. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014; 35(41): 2873–2926.
- Jiang CP, Wibisono AT, Pasang T. Selective laser melting of stainless steel 316L with face-centered-cubic-based lattice structures to produce rib implants. Materials (Basel). 2021; 14(20).
- Jansova, Magdalena & Hyncik, Ludek & Cechova, Hana & Toczyski, Jacek & Gierczycka-Zbrozek, Donata & Baudrit, Pascal. . Evaluation of human thorax FE model in various impact scenarios. Applied and Computational Mechanics. 2015; 9: 5–20.
- Giambini H, Wang HJ, Zhao C, et al. Anterior and posterior variations in mechanical properties of human vertebrae measured by nanoindentation. J Biomech. 2013; 46(3): 456–461.
- Gao F, Watanabe M, Matsuzawa T. Stress analysis in a layered aortic arch model under pulsatile blood flow. Biomed Eng Online. 2006; 5: 25.
- Huyer LD, Montgomery M, Zhao Y, et al. Biomaterial based cardiac tissue engineering and its applications. Biomed Mater. 2015; 10(3): 034004.
- Emig R, Zgierski-Johnston CM, Timmermann V, et al. Passive myocardial mechanical properties: meaning, measurement, models. Biophys Rev. 2021; 13(5): 587–610.
- Dulińska I, Targosz M, Strojny W, et al. Stiffness of normal and pathological erythrocytes studied by means of atomic force microscopy. J Biochem Biophys Methods. 2006; 66(1-3): 1–11.
- Kim Y, Kim K, Park Y. Measurement techniques for red blood cell deformability: recent advances. Blood Cell - An Overview of Studies in Hematology. 2012.
- Habibi R, Devendran C, Neild A. Trapping and patterning of large particles and cells in a 1D ultrasonic standing wave. Lab Chip. 2017; 17(19): 3279–3290.
- Al-Mayah A, Moseley J, Velec M, et al. Sliding characteristic and material compressibility of human lung: parametric study and verification. Med Phys. 2009; 36(10): 4625–4633.
- Zeng YJ, Yager D, Fung YC. Measurement of the mechanical properties of the human lung tissue. J Biomech Eng. 1987; 109(2): 169–174.
- Seyfi Noferest, Behnaz, "Inverse-Consistent Determination of Young's Modulus of Human Lung" . Electronic Theses and Dissertations. 2015; 5149.
- HajHosseini, P., & takalloozadeh, M. . An isotropic hyperelastic model of esophagus tissue layers along with three-dimensional simulation of esophageal peristaltic behavior. Journal of Bioengineering Research. 2019; 1(2): 12–27.
- Comley K, Fleck N. A micromechanical model for the Young’s modulus of adipose tissue. Int J Solids Struct. 2010; 47(21): 2982–2990.
- Carrera E, Guarnera D, Pagani A. Static and free-vibration analyses of dental prosthesis and atherosclerotic human artery by refined finite element models. Biomech Model Mechanobiol. 2018; 17(2): 301–317.
- Yang KH, Hu J, White NA, et al. Development of numerical models for injury biomechanics research: a review of 50 years of publications in the Stapp Car Crash Conference. Stapp Car Crash J. 2006; 50: 429–490.
- Wang, Hui-Chang Kevin, Development of a Side Impact Finite Element Human Thoracic Model [PhD thesis]. Detroit, MI: Wayne State University. ; 1995.
- Shah CS, Yang KH, Hardy W, et al. Development of a computer model to predict aortic rupture due to impact loading. Stapp Car Crash J. 2001; 45: 161–182.
- Khosravi A, Bani MS, Bahreinizade H, et al. A computational fluid-structure interaction model to predict the biomechanical properties of the artificial functionally graded aorta. Biosci Rep. 2016; 36(6).
- Dabagh M, Jalali P, Konttinen YT, et al. Distribution of shear stress over smooth muscle cells in deformable arterial wall. Med Biol Eng Comput. 2008; 46(7): 649–657.
- Towfiq BA, Weir J, Rawles JM. Effect of age and blood pressure on aortic size and stroke distance. Br Heart J. 1986; 55(6): 560–568.
- Wolak A, Gransar H, Thomson LEJ, et al. Aortic size assessment by noncontrast cardiac computed tomography: normal limits by age, gender, and body surface area. JACC Cardiovasc Imaging. 2008; 1(2): 200–209.
- Vasava P, Jalali P, Dabagh M, et al. Finite element modelling of pulsatile blood flow in idealized model of human aortic arch: study of hypotension and hypertension. Comput Math Methods Med. 2012; 2012: 861837.
- Grave-Capistrán MA, Prieto-Vázquez AY, Torres-SanMiguel CR. Aortic Blunt Trauma Analysis during a Frontal Impact. Appl Bionics Biomech. 2021; 2021: 5555218.
- Siegel JH, Yang KH, Smith JA, et al. Computer simulation and validation of the Archimedes Lever hypothesis as a mechanism for aortic isthmus disruption in a case of lateral impact motor vehicle crash: a Crash Injury Research Engineering Network (CIREN) study. J Trauma. 2006; 60(5): 1072–1082.
- Richens D, Field M, Hashim S, et al. A finite element model of blunt traumatic aortic rupture. Eur J Cardiothorac Surg. 2004; 25(6): 1039–1047.
- Belwadi A, Siegel JH, Singh A, et al. Finite element aortic injury reconstruction of near side lateral impacts using real world crash data. J Biomech Eng. 2012; 134(1): 011006.
- Hardy WN, Shah CS, Mason MJ, et al. Mechanisms of traumatic rupture of the aorta and associated peri-isthmic motion and deformation. Stapp Car Crash J. 2008; 52: 233–265.
- Richens D, Field M, Neale M, et al. The mechanism of injury in blunt traumatic rupture of the aorta. Eur J Cardiothorac Surg. 2002; 21(2): 288–293.
- Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation. 1995; 92(5): 1355–1374.
- Stary HC, Chandler AB, Glagov S, et al. A definition of initial, fatty streak, and intermediate lesions of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb. 1994; 14(5): 840–856.
- Sznol JA, Koru-Sengul T, Graygo J, et al. Etiology of fatal thoracic aortic injuries: Secondary data analysis. Traffic Inj Prev. 2016; 17(2): 209–216.
- Lorkowski J, Kolaszyńska O, Pokorski M. Artificial intelligence and precision medicine: a perspective. Adv Exp Med Biol. 2022; 1375: 1–11.
- Liang L, Liu M, Elefteriades J, et al. Synergistic integration of deep neural networks and finite element method with applications for biomechanical analysis of human aorta. bioRxiv. 2023.
- McKee CT, Last JA, Russell P, et al. Indentation versus tensile measurements of Young's modulus for soft biological tissues. Tissue Eng Part B Rev. 2011; 17(3): 155–164.
- Horton TG, Cohn SM, Heid MP, et al. Identification of trauma patients at risk of thoracic aortic tear by mechanism of injury. J Trauma. 2000; 48(6): 1008–13; discussion 1013.
- Lorenzo AH. Wilhelmi, M., & Anduaga, A. M. . Traumatismo torácico y rotura aórtica. Puesta al día en urgencias, emergencias y catástrofes. 2009; 9: 134–145.