1
|
Arrarte Terreros N, Renon S, Zucchelli F, Bridio S, Rodriguez Matas JF, Dubini G, Konduri PR, Koopman MS, van Zwam WH, Yo LSF, Lo RH, Marquering HA, van Bavel E, Majoie CBLM, Migliavacca F, Luraghi G. Microcatheter tracking in thrombectomy procedures: A finite-element simulation study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 234:107515. [PMID: 37011425 DOI: 10.1016/j.cmpb.2023.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/14/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Mechanical thrombectomy is a minimally invasive procedure that aims at removing the occluding thrombus from the vasculature of acute ischemic stroke patients. Thrombectomy success and failure can be studied using in-silico thrombectomy models. Such models require realistic modeling steps to be effective. We here present a new approach to model microcatheter tracking during thrombectomy. METHODS For 3 patient-specific vessel geometries, we performed finite-element simulations of the microcatheter tracking (1) following the vessel centerline (centerline method) and (2) as a one-step insertion simulation, where the microcatheter tip was advanced along the vessel centerline while its body was free to interact with the vessel wall (tip-dragging method). Qualitative validation of the two tracking methods was performed with the patient's digital subtraction angiography (DSA) images. In addition, we compared simulated thrombectomy outcomes (successful vs unsuccessful thrombus retrieval) and maximum principal stresses on the thrombus between the centerline and tip-dragging method. RESULTS Qualitative comparison with the DSA images showed that the tip-dragging method more realistically resembles the patient-specific microcatheter-tracking scenario, where the microcatheter approaches the vessel walls. Although the simulated thrombectomy outcomes were similar in terms of thrombus retrieval, the thrombus stress fields (and the associated fragmentation of the thrombus) were strongly different between the two methods, with local differences in the maximum principal stress curves up to 84%. CONCLUSIONS Microcatheter positioning with respect to the vessel affects the stress fields of the thrombus during retrieval, and therefore, may influence thrombus fragmentation and retrieval in-silico thrombectomy.
Collapse
Affiliation(s)
- Nerea Arrarte Terreros
- Department of Biomedical Engineering and Physics, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Silvia Renon
- Computational Biomechanics Laboratory, Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza L. da Vinci 32, Milan 20133, Italy
| | - Francesca Zucchelli
- Computational Biomechanics Laboratory, Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza L. da Vinci 32, Milan 20133, Italy
| | - Sara Bridio
- Computational Biomechanics Laboratory, Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza L. da Vinci 32, Milan 20133, Italy
| | - Jose Felix Rodriguez Matas
- Computational Biomechanics Laboratory, Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza L. da Vinci 32, Milan 20133, Italy
| | - Gabriele Dubini
- Computational Biomechanics Laboratory, Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza L. da Vinci 32, Milan 20133, Italy
| | - Praneeta R Konduri
- Department of Biomedical Engineering and Physics, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Miou S Koopman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Wim H van Zwam
- Department of Radiology and Nuclear Medicine, Maastricht UMC, Maastricht, the Netherlands
| | - Lonneke S F Yo
- Department of Radiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Rob H Lo
- Department of Radiology, UMC Utrecht, Utrecht, the Netherlands
| | - Henk A Marquering
- Department of Biomedical Engineering and Physics, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Ed van Bavel
- Department of Biomedical Engineering and Physics, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Charles B L M Majoie
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Francesco Migliavacca
- Computational Biomechanics Laboratory, Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza L. da Vinci 32, Milan 20133, Italy
| | - Giulia Luraghi
- Computational Biomechanics Laboratory, Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza L. da Vinci 32, Milan 20133, Italy.
| |
Collapse
|
2
|
Huang X, Zhang G, Zhou X, Yang X. A review of numerical simulation in transcatheter aortic valve replacement decision optimization. Clin Biomech (Bristol, Avon) 2023; 106:106003. [PMID: 37245279 DOI: 10.1016/j.clinbiomech.2023.106003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Recent trials indicated a further expansion of clinical indication of transcatheter aortic valve replacement to younger and low-risk patients. Factors related to longer-term complications are becoming more important for use in these patients. Accumulating evidence indicates that numerical simulation plays a significant role in improving the outcome of transcatheter aortic valve replacement. Understanding mechanical features' magnitude, pattern, and duration is a topic of ongoing relevance. METHODS We searched the PubMed database using keywords such as "transcatheter aortic valve replacement" and "numerical simulation" and reviewed and summarized relevant literature. FINDINGS This review integrated recently published evidence into three subtopics: 1) prediction of transcatheter aortic valve replacement outcomes through numerical simulation, 2) implications for surgeons, and 3) trends in transcatheter aortic valve replacement numerical simulation. INTERPRETATIONS Our study offers a comprehensive overview of the utilization of numerical simulation in the context of transcatheter aortic valve replacement, and highlights the advantages, potential challenges from a clinical standpoint. The convergence of medicine and engineering plays a pivotal role in enhancing the outcomes of transcatheter aortic valve replacement. Numerical simulation has provided evidence of potential utility for tailored treatments.
Collapse
Affiliation(s)
- Xuan Huang
- Department of Cardiovascular Surgery, West China Biomedical Big Data Center, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, China
| | - Guangming Zhang
- Center for Computational Systems Medicine, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Xiaobo Zhou
- Center for Computational Systems Medicine, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Xiaoyan Yang
- Department of Cardiovascular Surgery, West China Biomedical Big Data Center, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
3
|
Badrou A, Tardif N, Chaudet P, Lescanne N, Szewczyk J, Blanc R, Hamila N, Gravouil A, Bel-Brunon A. Simulation of multi-curve active catheterization for endovascular navigation to complex targets. J Biomech 2022; 140:111147. [DOI: 10.1016/j.jbiomech.2022.111147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
|
4
|
Abuouf Y, Ookawara S, Ahmed M. Analysis of the effect of guidewire position on stenosis diagnosis using computational fluid dynamics. Comput Biol Med 2020; 121:103777. [PMID: 32568672 DOI: 10.1016/j.compbiomed.2020.103777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Fractional flow reserve is an accurate method for diagnosing stenosis. The difficulty in using this procedure lies in placing the guidewire precisely at the blood vessel centerline. Owing to the long distance between the insertion point and the stenosis, a guidewire inclination can occur. Therefore, the main objective of this study is to investigate how the measured pressure in a blood vessel varies with the guidewire position. METHODS A three-dimensional model of blood flow is developed and numerically simulated. Two positions and two inclination angles from the blood vessel centerline and three throat diameters are investigated. The predicted results are validated using the available experimental data. The predicted results and actual measurements are observed to agree well with each other. RESULTS The pressure drop coefficient (CDP) increases because of guidewire insertion. When the guidewire is placed at inclined positions in moderate stenosis, the values of CDP are 66 and 68, depending on the inclination angle; the errors in CDP are 69% and 76%, respectively. At a high flow rate, the errors are reduced to 67% and 70%, respectively. The error in the CDP ranges from 42% to 61% when the guidewire is placed parallel to the centerline. For severe stenosis, the CDP is nearly the same at all positions and varies between 240 and 250; without a guidewire, the CDP is 163. CONCLUSIONS The findings confirmed that practitioners should be aware of the guidewire position during the operation. The displacement of the guidewire should be estimated, and the corresponding error must be considered.
Collapse
Affiliation(s)
- Yasser Abuouf
- Department of Energy Resources Engineering, Egypt-Japan University of Science and Technology (E-JUST), P.O. Box 179, New Borg El-Arab City, Postal Code 21934, Alexandria, Egypt.
| | - Shinichi Ookawara
- Department of Energy Resources Engineering, Egypt-Japan University of Science and Technology (E-JUST), P.O. Box 179, New Borg El-Arab City, Postal Code 21934, Alexandria, Egypt; Department of Chemical Engineering, Graduate School of Science and Engineering, Tokyo Institute of Technology, O-okayama, Meguro-ku, Tokyo, 152-8552, Japan.
| | - Mahmoud Ahmed
- Department of Energy Resources Engineering, Egypt-Japan University of Science and Technology (E-JUST), P.O. Box 179, New Borg El-Arab City, Postal Code 21934, Alexandria, Egypt; Mechanical Engineering Department, Assiut University, Assiut, 71516, Egypt.
| |
Collapse
|