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Kadry K, Olender ML, Marlevi D, Edelman ER, Nezami FR. A platform for high-fidelity patient-specific structural modelling of atherosclerotic arteries: from intravascular imaging to three-dimensional stress distributions. J R Soc Interface 2021; 18:20210436. [PMID: 34583562 DOI: 10.1098/rsif.2021.0436] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The pathophysiology of atherosclerotic lesions, including plaque rupture triggered by mechanical failure of the vessel wall, depends directly on the plaque morphology-modulated mechanical response. The complex interplay between lesion morphology and structural behaviour can be studied with high-fidelity computational modelling. However, construction of three-dimensional (3D) and heterogeneous models is challenging, with most previous work focusing on two-dimensional geometries or on single-material lesion compositions. Addressing these limitations, we here present a semi-automatic computational platform, leveraging clinical optical coherence tomography images to effectively reconstruct a 3D patient-specific multi-material model of atherosclerotic plaques, for which the mechanical response is obtained by structural finite-element simulations. To demonstrate the importance of including multi-material plaque components when recovering the mechanical response, a computational case study was conducted in which systematic variation of the intraplaque lipid and calcium was performed. The study demonstrated that the inclusion of various tissue components greatly affected the lesion mechanical response, illustrating the importance of multi-material formulations. This platform accordingly provides a viable foundation for studying how plaque micro-morphology affects plaque mechanical response, allowing for patient-specific assessments and extension into clinically relevant patient cohorts.
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Affiliation(s)
- Karim Kadry
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,Laboratory of Hemodynamics and Cardiovascular Technology, Swiss Federal Institute of Technology, MED 3.2922, 1015 Lausanne, Switzerland
| | - Max L Olender
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - David Marlevi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Elazer R Edelman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Farhad R Nezami
- Thoracic and Cardiac Surgery Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Pozzi S, Domanin M, Forzenigo L, Votta E, Zunino P, Redaelli A, Vergara C. A surrogate model for plaque modeling in carotids based on Robin conditions calibrated by cine MRI data. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3447. [PMID: 33586336 DOI: 10.1002/cnm.3447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
We propose a surrogate model for the fluid-structure interaction (FSI) problem for the study of blood dynamics in carotid arteries in presence of plaque. This is based on the integration of a numerical model with subject-specific data and clinical imaging. We propose to model the plaque as part of the tissues surrounding the vessel wall through the application of an elastic support boundary condition. In order to characterize the plaque and other surrounding tissues, such as the close-by jugular vein, the elastic parameters of the boundary condition were spatially differentiated and their values were estimated by minimizing the discrepancies between computed vessel displacements and reference values obtained from CINE Magnetic Resonance Imaging data. We applied the model to three subjects with a degree of stenosis greater than 70%. We found that accounting for both plaque and jugular vein in the estimation of the elastic parameters increases the accuracy. In particular, in all patients, mismatches between computed and in vivo measured wall displacements were one to two orders of magnitude lower than the spatial resolution of the original MRI data. These results confirmed the validity of the proposed surrogate plaque model. We also compared fluid-dynamics results with those obtained in a fixed wall setting and in a full FSI model, used as gold standard, highlighting the better accordance of our results in comparison to the rigid ones.
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Affiliation(s)
- Silvia Pozzi
- MOX, Department of Mathematics, Politecnico di Milano, Milan, Italy
| | - Maurizio Domanin
- Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy
- Unità Operativa di Chirurgia Vascolare, Fondazione I.R.C.C.S. Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Forzenigo
- Unità Operativa di Radiologia, Fondazione I.R.C.C.S. Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Emiliano Votta
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Paolo Zunino
- MOX, Department of Mathematics, Politecnico di Milano, Milan, Italy
| | - Alberto Redaelli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Christian Vergara
- LaBS, Dipartimento di Chimica, Materiali e Ingegneria Chimica "Giulio Natta", Politecnico di Milano, Milan, Italy
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Siogkas PK, Papafaklis MI, Gogas BD, Samady H, Michalis LK, Fotiadis DI. Computational estimation of the severity of coronary lesions with intravascular ultrasound images: a pilot study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:2664-2667. [PMID: 28268869 DOI: 10.1109/embc.2016.7591278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The fast and accurate hemodynamic functional assessment of the coronary vasculature is of utmost importance in clinical practice due to the fact that Cardiovascular Diseases have become the leading cause of death globally. In this work we propose a novel method that combines two of the most efficient methods of hemodynamic status assessment of coronary arteries, Intravascular UtraSound and virtual Functional Assessment Index, an index that correlates well to the measured Fractional Flow Reserve. One Left Anterior Descending segment was reconstructed both in a straight manner (using only IVUS images) as well as using the actual 3D geometry of the vessel (using IvUS images combined with the respective coronary angiographic images [2]). The generated vFAI values were almost identical (Straight=0.80, 3D=0.79), presenting a relative error of 1.27%, thus proving the efficacy of the proposed method. We also calculated the Endothelial Shear Stress for the two models under rest (i.e. flow rate of 1 ml/s), observing a similar trend throughout the artery, but with a statistically important relative error of 13.49%, as expected.
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Siogkas PK, Athanasiou LS, Sakellarios AI, Stefanou KA, Exarchos TP, Papafaklis MI, Naka KK, Parodi O, Michalis LK, Fotiadis DI. Validation study of a 3D-QCA coronary reconstruction method using a hybrid intravascular ultrasound and angiography reconstruction method and patient-specific Fractional Flow Reserve data. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:973-6. [PMID: 26736426 DOI: 10.1109/embc.2015.7318526] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The estimation of the severity of coronary lesions is of utmost importance in today's clinical practice, since Cardiovascular diseases often have fatal consequences. The most efficient method to estimate the severity of a lesion is the calculation of the Fractional Flow Reserve. The necessary use of a pressure wire, however, makes this method invasive and strenuous for the patient. In this work, we present a novel 3-Dimensional Quantitative Coronary Analysis coronary reconstruction method and a framework for the computation of the virtual Functional Assessment Index (vFAI). In a dataset of 5 coronary arterial segments, we use the aforementioned method to reconstruct them in 3D, and compare them to the respective 3D models reconstructed from our already validated hybrid IVUS-angiography reconstruction method [2]. The obtained results indicate a high correlation between the two methods in terms of the calculated FFR values, presenting a difference of 3.19% in the worst case scenario. Furthermore, when compared to the actual FFR values that derive from a pressure wire, the differences were statistically insignificant.
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Siogkas PK, Papafaklis MI, Sakellarios AI, Stefanou KA, Bourantas CV, Athanasiou LM, Bellos CV, Exarchos TP, Naka KK, Michalis LK, Parodi O, Fotiadis DI. Computational assessment of the fractional flow reserve from intravascular ultrasound and coronary angiography data: a pilot study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2013:3885-8. [PMID: 24110580 DOI: 10.1109/embc.2013.6610393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Cardiovascular disease is one of the primary causes of morbidity and mortality around the globe. Thus, the diagnosis of critical lesions in coronary arteries is of utmost importance in clinical practice. One useful and efficient method to assess the functional severity of one or multiple lesions in a coronary artery is the calculation of the fractional flow reserve (FFR). In the current work, we present a method which allows the calculation of the FFR value computationally, without the use of a pressure wire and the induction of hyperemia, using intravascular ultrasound (IVUS) and biplane angiography images for three-dimensional (3D) coronary artery reconstruction and measurements of the volumetric flow rate derived from angiographic sequences. The simulated FFR values were compared to the invasively measured FFR values in 7 cases, presenting high correlation (r=0.85) and good agreement (mean difference=0.002). FFR assessment without employing a pressure wire and the induction of hyperemia is feasible using 3D reconstructed coronary artery models from angiographic and IVUS data coupled with computational fluid dynamics.
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Patient-specific simulation of coronary artery pressure measurements: an in vivo three-dimensional validation study in humans. BIOMED RESEARCH INTERNATIONAL 2015; 2015:628416. [PMID: 25815328 PMCID: PMC4359837 DOI: 10.1155/2015/628416] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/10/2014] [Indexed: 02/04/2023]
Abstract
Pressure measurements using finite element computations without the need of a wire could be valuable in clinical practice. Our aim was to compare the computed distal coronary pressure values with the measured values using a pressure wire, while testing the effect of different boundary conditions for the simulation. Eight coronary arteries (lumen and outer vessel wall) from six patients were reconstructed in three-dimensional (3D) space using intravascular ultrasound and biplane angiographic images. Pressure values at the distal and proximal end of the vessel and flow velocity values at the distal end were acquired with the use of a combo pressure-flow wire. The 3D lumen and wall models were discretized into finite elements; fluid structure interaction (FSI) and rigid wall simulations were performed for one cardiac cycle both with pulsatile and steady flow in separate simulations. The results showed a high correlation between the measured and the computed coronary pressure values (coefficient of determination [r2] ranging between 0.8902 and 0.9961), while the less demanding simulations using steady flow and rigid walls resulted in very small relative error. Our study demonstrates that computational assessment of coronary pressure is feasible and seems to be accurate compared to the wire-based measurements.
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Siogkas PK, Sakellarios AI, Papafaklis MI, Stefanou KA, Athanasiou LM, Exarchos TP, Naka KK, Michalis LK, Fotiadis DI. Assessing the hemodynamic influence between multiple lesions in a realistic right coronary artery segment: A computational study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:5643-6. [PMID: 25571275 DOI: 10.1109/embc.2014.6944907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Coronary artery disease is the primary cause of morbidity and mortality worldwide. Therefore, detailed assessment of lesions in the coronary vasculature is critical in current clinical practice. Fractional flow reserve (FFR) has been proven as an efficient method for assessing the hemodynamic severity of a coronary stenosis. However, functional assessment of a coronary segment with multiple stenoses (≥ 2) remains complex for guiding the strategy of percutaneous coronary intervention due to the hemodynamic interplay between adjacent stenoses. In this work, we created four 3-dimensional (3D) arterial models that derive from a healthy patient-specific right coronary artery segment. The initial healthy model was reconstructed using fusion of intravascular ultrasound (IVUS) and biplane angiographic patient data. The healthy 3D model presented a measured FFR value of 0.96 (pressure-wire) and a simulated FFR value of 0.98. We then created diseased models with two artificial sequential stenoses of 90% lumen area reduction or with the proximal and distal stenosis separately. We calculated the FFR value for each case: 0.65 for the case with the two stenoses, 0.73 for the case with the distal stenosis and 0.90 for the case with the proximal stenosis. This leads to the conclusion that although both stenoses had the same degree of lumen area stenosis, there was a large difference in hemodynamic severity, thereby indicating that angiographic lumen assessment by itself is often not adequate for accurate assessment of coronary lesions.
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Zhao W, Ming A, Shimojo M, Inoue Y, Maekawa H. Fluid-Structure Interaction Analysis of a Soft Robotic Fish Using Piezoelectric Fiber Composite. JOURNAL OF ROBOTICS AND MECHATRONICS 2014. [DOI: 10.20965/jrm.2014.p0638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
<div class=""abs_img""><img src=""[disp_template_path]/JRM/abst-image/00260005/13.jpg"" width=""300"" />Model of soft robotic fish</div> Designing a high-performance soft robotic fish requires considering the interaction between the flexible robot structure and surrounding fluid. This paper introduces fluid-structure interaction (FSI) analysis used to enhance the hydrodynamic performance of soft robotic fish using piezoelectric fiber composite (PFC) as the propulsion actuator. The basic FSI analysis scheme for soft robotic fish is presented, then the numerical model of the actuator, robot structure, and surrounding fluid are described based on the FSI analysis scheme. The FSI analysis of the soft robotic fish is performed through these numerical models. To evaluate the effectiveness of FSI analysis, coupling simulation and experimental results are compared. We found that the calculated results of propulsive force and deformation displacement were similar to those for experiments. These results suggest that FSI analysis is useful and is applicable to evaluating propulsion characteristics of the soft robotic fish to improve performance. </span>
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Park S, Lee SW, Lim OK, Min I, Nguyen M, Ko YB, Yoon K, Suh DC. Computational modeling with fluid-structure interaction of the severe m1 stenosis before and after stenting. Neurointervention 2013; 8:23-8. [PMID: 23515355 PMCID: PMC3601276 DOI: 10.5469/neuroint.2013.8.1.23] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 01/17/2013] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Image-based computational models with fluid-structure interaction (FSI) can be used to perform plaque mechanical analysis in intracranial artery stenosis. We described a process in FSI study applied to symptomatic severe intracranial (M1) stenosis before and after stenting. MATERIALS AND METHODS Reconstructed 3D angiography in STL format was transferred to Magics for smoothing of vessel surface and trimming of branch vessels and to HyperMesh for generating tetra volume mesh from triangular surface-meshed 3D angiogram. Computational analysis of blood flow in the blood vessels was performed using the commercial finite element software ADINA Ver 8.5. The distribution of wall shear stress (WSS), peak velocity and pressure was analyzed before and after intracranial stenting. RESULTS The wall shear stress distributions from Computational fluid dynamics (CFD) simulation with rigid wall assumption as well as FSI simulation before and after stenting could be compared. The difference of WSS between rigid wall and compliant wall model both in pre- and post-stent case is only minor except at the stenosis region. These WSS values were greatly reduced after stenting to 15~20 Pa at systole and 3~5 Pa at end-diastole in CFD simulation, which are similar in FSI simulations. CONCLUSION Our study revealed that FSI simulation before and after intracranial stenting was feasible despite of limited vessel wall dimension and could reveal change of WSS as well as flow velocity and wall pressure.
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Affiliation(s)
- Soonchan Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea
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Leach JR, Rayz VL, Soares B, Wintermark M, Mofrad MRK, Saloner D. Carotid atheroma rupture observed in vivo and FSI-predicted stress distribution based on pre-rupture imaging. Ann Biomed Eng 2010; 38:2748-65. [PMID: 20232151 PMCID: PMC2900591 DOI: 10.1007/s10439-010-0004-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 03/04/2010] [Indexed: 11/13/2022]
Abstract
Atherosclerosis at the carotid bifurcation is a major risk factor for stroke. As mechanical forces may impact lesion stability, finite element studies have been conducted on models of diseased vessels to elucidate the effects of lesion characteristics on the stresses within plaque materials. It is hoped that patient-specific biomechanical analyses may serve clinically to assess the rupture potential for any particular lesion, allowing better stratification of patients into the most appropriate treatments. Due to a sparsity of in vivo plaque rupture data, the relationship between various mechanical descriptors such as stresses or strains and rupture vulnerability is incompletely known, and the patient-specific utility of biomechanical analyses is unclear. In this article, we present a comparison between carotid atheroma rupture observed in vivo and the plaque stress distribution from fluid–structure interaction analysis based on pre-rupture medical imaging. The effects of image resolution are explored and the calculated stress fields are shown to vary by as much as 50% with sub-pixel geometric uncertainty. Within these bounds, we find a region of pronounced elevation in stress within the fibrous plaque layer of the lesion with a location and extent corresponding to that of the observed site of plaque rupture.
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Affiliation(s)
- Joseph R Leach
- UC Berkeley/UC San Francisco Joint Graduate Group in Bioengineering, Berkeley, CA, USA.
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