1
|
van de Velde L, Groot Jebbink E, Hagmeijer R, Versluis M, Reijnen MMPJ. Computational Fluid Dynamics for the Prediction of Endograft Thrombosis in the Superficial Femoral Artery. J Endovasc Ther 2023; 30:615-627. [DOI: https:/doi.org/10.1177/15266028221091890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Purpose: Contemporary diagnostic modalities, including contrast-enhanced computed tomography (CTA) and duplex ultrasound, have been insufficiently able to predict endograft thrombosis. This study introduces an implementation of image-based computational fluid dynamics (CFD), by exemplification with 4 patients treated with an endograft for occlusive disease of the superficial femoral artery (SFA). The potential of personalized CFD for predicting endograft thrombosis is investigated. Materials and Methods: Four patients treated with endografts for an occluded SFA were retrospectively included. CFD simulations, based on CTA and duplex ultrasound, were compared for patients with and without endograft thrombosis to investigate potential flow-related causes of endograft thrombosis. Time-averaged wall shear stress (TAWSS) was computed, which highlights areas of prolonged residence times of coagulation factors in the graft. Results: CFD simulations demonstrated normal TAWSS (>0.4 Pa) in the SFA for cases 1 and 2, but low levels of TAWSS (<0.4 Pa) in cases 3 and 4, respectively. Primary patency was achieved in cases 1 and 2 for over 2 year follow-up. Cases 3 and 4 were complicated by recurrent endograft thrombosis. Conclusion: The presence of a low TAWSS was associated with recurrent endograft thrombosis in subjects with otherwise normal anatomic and ultrasound assessment and a good distal run-off.
Collapse
Affiliation(s)
- Lennart van de Velde
- Department of Surgery, Ziekenhuis Rijnstate, Arnhem, The Netherlands
- Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Physics of Fluids Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Erik Groot Jebbink
- Department of Surgery, Ziekenhuis Rijnstate, Arnhem, The Netherlands
- Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Rob Hagmeijer
- Engineering Fluid Dynamics, University of Twente, Enschede, The Netherlands
| | - Michel Versluis
- Physics of Fluids Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Michel M. P. J. Reijnen
- Department of Surgery, Ziekenhuis Rijnstate, Arnhem, The Netherlands
- Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| |
Collapse
|
2
|
van de Velde L, Groot Jebbink E, Hagmeijer R, Versluis M, Reijnen MMPJ. Computational Fluid Dynamics for the Prediction of Endograft Thrombosis in the Superficial Femoral Artery. J Endovasc Ther 2022:15266028221091890. [PMID: 35466777 DOI: 10.1177/15266028221091890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Contemporary diagnostic modalities, including contrast-enhanced computed tomography (CTA) and duplex ultrasound, have been insufficiently able to predict endograft thrombosis. This study introduces an implementation of image-based computational fluid dynamics (CFD), by exemplification with 4 patients treated with an endograft for occlusive disease of the superficial femoral artery (SFA). The potential of personalized CFD for predicting endograft thrombosis is investigated. MATERIALS AND METHODS Four patients treated with endografts for an occluded SFA were retrospectively included. CFD simulations, based on CTA and duplex ultrasound, were compared for patients with and without endograft thrombosis to investigate potential flow-related causes of endograft thrombosis. Time-averaged wall shear stress (TAWSS) was computed, which highlights areas of prolonged residence times of coagulation factors in the graft. RESULTS CFD simulations demonstrated normal TAWSS (>0.4 Pa) in the SFA for cases 1 and 2, but low levels of TAWSS (<0.4 Pa) in cases 3 and 4, respectively. Primary patency was achieved in cases 1 and 2 for over 2 year follow-up. Cases 3 and 4 were complicated by recurrent endograft thrombosis. CONCLUSION The presence of a low TAWSS was associated with recurrent endograft thrombosis in subjects with otherwise normal anatomic and ultrasound assessment and a good distal run-off.
Collapse
Affiliation(s)
- Lennart van de Velde
- Department of Surgery, Ziekenhuis Rijnstate, Arnhem, The Netherlands.,Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands.,Physics of Fluids Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Erik Groot Jebbink
- Department of Surgery, Ziekenhuis Rijnstate, Arnhem, The Netherlands.,Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Rob Hagmeijer
- Engineering Fluid Dynamics, University of Twente, Enschede, The Netherlands
| | - Michel Versluis
- Physics of Fluids Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Michel M P J Reijnen
- Department of Surgery, Ziekenhuis Rijnstate, Arnhem, The Netherlands.,Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| |
Collapse
|
3
|
Ong CW, Kumar GP, Zuo K, Koh LB, Charles CJ, Ho P, Leo HL, Cui F. A novel coating method to reduce membrane infolding through pre-crimping of covered stents – Computationaland experimental evaluation. Comput Biol Med 2022; 145:105524. [DOI: 10.1016/j.compbiomed.2022.105524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 11/24/2022]
|
4
|
Saxena A, Ng EYK, Canchi T, Tee JJ, Ng LK. Relation Between Neck Skin Temperature Measurement and Carotid Artery Stenosis: In-Vitro Evaluation. J Biomech Eng 2020; 142:114501. [PMID: 32914828 DOI: 10.1115/1.4048423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Indexed: 11/08/2022]
Abstract
Carotid artery stenosis is a form of atherosclerosis, where thrombus formation restricts the passage of blood through the carotid artery leading to irreversible damage in the brain tissue. The presence of stenosis in the carotid artery results in abnormal temperature maps on the external skin surface, which can be captured and quantified using noncontact/noninvasive infrared (IR) thermal imaging/thermography. In this study, a thermally charged in vitro carotid artery flow loop, using 0% and 75% stenosis models, was designed to study the thermal effect on the external skin surface. The carotid artery flow was encapsulated with polydimethylsiloxane (PDMS) resembling neck tissue, of which the external surface temperature maps were studied using IR thermography. Using the mean temperature as a threshold value, the resultant thermal image was processed and normalized. Between the two stenosis models, disruption in the thermal features corresponding to the presence of stenosis was observed. The method described in this study paves the path to experimentally study the thermal effect of the presence of stenosis in the carotid artery.
Collapse
Affiliation(s)
- Ashish Saxena
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Block N3, Nanyang Ave, Singapore 639798
| | - Eddie Yin Kwee Ng
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Block N3, Nanyang Ave, Singapore 639798
| | - Tejas Canchi
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Block N3, Nanyang Ave, Singapore 639798
| | - Jun Jie Tee
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Block N3, Nanyang Ave, Singapore 639798
| | - Lip Koon Ng
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Block N3, Nanyang Ave, Singapore 639798
| |
Collapse
|
5
|
Hoving AM, de Vries EE, Mikhal J, de Borst GJ, Slump CH. A Systematic Review for the Design of In Vitro Flow Studies of the Carotid Artery Bifurcation. Cardiovasc Eng Technol 2020; 11:111-127. [PMID: 31823191 PMCID: PMC7082306 DOI: 10.1007/s13239-019-00448-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 12/02/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE In vitro blood flow studies in carotid artery bifurcation models may contribute to understanding the influence of hemodynamics on carotid artery disease. However, the design of in vitro blood flow studies involves many steps and selection of imaging techniques, model materials, model design, and flow visualization parameters. Therefore, an overview of the possibilities and guidance for the design process is beneficial for researchers with less experience in flow studies. METHODS A systematic search to in vitro flow studies in carotid artery bifurcation models aiming at quantification and detailed flow visualization of blood flow dynamics results in inclusion of 42 articles. RESULTS Four categories of imaging techniques are distinguished: MRI, optical particle image velocimetry (PIV), ultrasound and miscellaneous techniques. Parameters for flow visualization are categorized into velocity, flow, shear-related, turbulent/disordered flow and other parameters. Model materials and design characteristics vary between study type. CONCLUSIONS A simplified three-step design process is proposed for better fitting and adequate match with the pertinent research question at hand and as guidance for less experienced flow study researchers. The three consecutive selection steps are: flow parameters, image modality, and model materials and designs. Model materials depend on the chosen imaging technique, whereas choice of flow parameters is independent from imaging technique and is therefore only determined by the goal of the study.
Collapse
Affiliation(s)
- A M Hoving
- University of Twente, 7500 AE, Enschede, The Netherlands.
| | - E E de Vries
- University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | - J Mikhal
- University of Twente, 7500 AE, Enschede, The Netherlands
| | - G J de Borst
- University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | - C H Slump
- University of Twente, 7500 AE, Enschede, The Netherlands
| |
Collapse
|
6
|
Masoud-Ansari S, Ormiston J, Webster M, Pontre B, Cowan B, Beier S. Towards validating stent induced micro flow patterns in left main coronary artery bifurcations. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:5749-5752. [PMID: 31947158 DOI: 10.1109/embc.2019.8856419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We investigated if blood flow changes induced through the presence of a stent could be detected using in vitro dynamically scaled 4D Phase-Contrast Magnetic Resonance Imaging (PC-MRI). Using idealized and patient-specific left main coronary artery bifurcations, we 3D-printed the dynamically large scaled geometries and incorporated them into a flow circuit for non-invasive acquisition with a higher effective spatial resolution. We tested the effects of using non-Newtonian and Newtonian fluids for the experiment. We also numerically simulated the same geometries in true scale for comparison using computational fluid dynamics (CFD). We found that the experimental setup increased the effective spatial resolution enough to reveal stent induced blood flow changes close to the vessel wall. Non-Newtonian fluid replicated all of the flow field well with a strong agreement with the computed flow field (R2 > 0.9). Fine flow structures were not as prominent for the Newtonian compared to non-Newtonian fluid consideration. In the patient-specific geometry, arterial non-planarity increased the difficulty to capture the near wall slow velocity changes. Findings demonstrate the potential to dynamically scale in vitro 4D MRI flow acquisition for micro blood flow considerations.
Collapse
|
7
|
Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation: a stereo-scopic PIV study. Sci Rep 2019; 9:11504. [PMID: 31395907 PMCID: PMC6687742 DOI: 10.1038/s41598-019-47873-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 06/24/2019] [Indexed: 11/22/2022] Open
Abstract
There has been a resurgence of interest in the treatment of severe functional tricuspid regurgitation (FTR) due to the awareness of its poor outcomes and potential percutaneous therapies. Kay bicuspidization has been adapted in percutaneous therapies but its clinical outcome remains uncertain. The present study evaluates the efficacy of Kay repair in a novel ex vivo pulsatile system. Porcine tricuspid valve (TV) (n = 3) was extracted and incorporated into a patient-specific silicon right ventricle (RV) emulating severe FTR, on which Kay repair was subsequently performed. TV area metrics and RV hemodynamic assessment by means of stereo-scopic particle image velocimetry were quantified in both FTR and post-repair conditions. Bicuspidization led to significant increase in cardiac output although the overall increment due to this approach alone was generally small, possibly due to existence of residual TR and the large reduction in TV opening area. Kinetic energy and viscous loss levels were increased post-repair, especially during diastolic filling. Main vortex structures generally maintained post-procedural. However, there was enhanced swirling motion in larger RV domain. Although this might reduce mural-thrombus risk, the relatively more complex vortex phenomenon likely resulted in elevated viscous loss observed and may potentially impact long-term adaptation. The RV hemodynamic alteration after tricuspid repair could be used to predict the success of these future transcatheter solutions.
Collapse
|
8
|
Morr S, Vakharia K, Fanous AA, Waqas M, Siddiqui AH. Utility of Intravascular Ultrasound During Carotid Angioplasty and Stenting with Proximal Protection. Cureus 2019; 11:e4935. [PMID: 31431840 PMCID: PMC6695231 DOI: 10.7759/cureus.4935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Carotid artery stenting (CAS) is an established treatment for patients at high-risk for endarterectomy. Patients who undergo CAS have been shown to have periprocedural microembolic events on transcranial Doppler ultrasonography. Flow reversal is often applied in these situations to prevent distal emboli and concurrently allow blood to flush into the common carotid artery. Patients who demonstrate soft plaque morphology that may embolize distally during CAS benefit from flow reversal. Even so, the all-stroke risk in these patients is nearly 1.4%. High-risk patients typically have more difficult plaque morphology; flow reversal decreases the rate of distal emboli but does not offer the intraprocedural visualization seen with intravascular ultrasound (IVUS). In this paper, we illustrate potential periprocedural outcomes associated with stenting of the stenotic carotid bifurcation under flow reversal and how IVUS influenced endovascular management. Three high-risk patients who underwent CAS with direct common carotid artery cutdown approaches due to common carotid ostia disease with flow-reversal proximal embolic protection also had intraprocedural IVUS performed to evaluate plaque morphology and stability before the protection system was removed. Case 1 illustrates no intraluminal thrombus on IVUS, requiring no further intervention after stent placement. Case 2 demonstrates intraluminal thrombus on IVUS requiring a second stent to stabilize plaque. Case 3 shows the inadequate resolution of thrombus after a second stent, which was addressed with balloon angioplasty. In our experience, using IVUS as an adjunct to CAS under proximal embolic protection helped demonstrate plaque morphology and plaque fragmentation after stent placement. These cases illustrate the potential benefit of allowing stabilization of the plaque before flow reversal is stopped.
Collapse
Affiliation(s)
- Simon Morr
- Neurosurgery, New York-Presbyterian Hospital-Columbia and Cornell, New York, USA
| | - Kunal Vakharia
- Neurosurgery, Gates Vascular Institute/Kaleida Health, Buffalo, USA
| | - Andrew A Fanous
- Neurosciences, INOVA Medical Group Neurosurgery, Alexandria, USA
| | - Muhammad Waqas
- Neurosurgery, Gates Vascular Institute/Kaleida Health, Buffalo, USA
| | - Adnan H Siddiqui
- Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA
| |
Collapse
|
9
|
Saxena A, Ng EYK, Lim ST. Imaging modalities to diagnose carotid artery stenosis: progress and prospect. Biomed Eng Online 2019; 18:66. [PMID: 31138235 PMCID: PMC6537161 DOI: 10.1186/s12938-019-0685-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/17/2019] [Indexed: 12/25/2022] Open
Abstract
In the past few decades, imaging has been developed to a high level of sophistication. Improvements from one-dimension (1D) to 2D images, and from 2D images to 3D models, have revolutionized the field of imaging. This not only helps in diagnosing various critical and fatal diseases in the early stages but also contributes to making informed clinical decisions on the follow-up treatment profile. Carotid artery stenosis (CAS) may potentially cause debilitating stroke, and its accurate early detection is therefore important. In this paper, the technical development of various CAS diagnosis imaging modalities and its impact on the clinical efficacy is thoroughly reviewed. These imaging modalities include duplex ultrasound (DUS), computed tomography angiography (CTA) and magnetic resonance angiography (MRA). For each of the imaging modalities considered, imaging methodology (principle), critical imaging parameters, and the extent of imaging the vulnerable plaque are discussed. DUS is usually the initial recommended CAS diagnostic examination. However, for the therapeutic intervention, either MRA or CTA is recommended for confirmation, and for added information on intracranial cerebral circulation and aortic arch condition for procedural planning. Over the past few decades, the focus of CAS diagnosis has also shifted from pure stenosis quantification to plaque characterization. This has led to further advancement in the existing imaging tools and development of other potential imaging tools like Optical coherence tomography (OCT), photoacoustic tomography (PAT), and infrared (IR) thermography.
Collapse
Affiliation(s)
- Ashish Saxena
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Ave, Block N3, Singapore, 639798, Singapore
| | - Eddie Yin Kwee Ng
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Ave, Block N3, Singapore, 639798, Singapore.
| | - Soo Teik Lim
- Department of Cardiology, National Heart Center Singapore, 5 Hospital Dr, Singapore, 169609, Singapore
| |
Collapse
|
10
|
Hemodynamic analysis of a novel stent graft design with slit perforations in thoracic aortic aneurysm. J Biomech 2019; 85:210-217. [DOI: 10.1016/j.jbiomech.2019.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/08/2018] [Accepted: 01/08/2019] [Indexed: 01/11/2023]
|
11
|
Fan D, Li L, Li Z, Zhang Y, Ma X, Wu L, Qin G. Effect of hyperlipidemia on the incidence of cardio-cerebrovascular events in patients with type 2 diabetes. Lipids Health Dis 2018; 17:102. [PMID: 29739462 PMCID: PMC5941465 DOI: 10.1186/s12944-018-0676-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 02/07/2018] [Indexed: 12/30/2022] Open
Abstract
Background This study was to explore the effect of hyperlipidemia on the incidence of cardio-cerebrovascular diseases in patients with type 2 diabetes. Methods Three hundred ninety five patients with type 2 diabetes in our hospital from January 2012 to January 2016 were followed up with an average of 3.8 years. The incidence of cardio-cerebrovascular diseases between diabetes combined with hyperlipidemia group (195 patients) and diabetes group (200 patients) were made a comparison. Multivariable Cox’s proportional hazards regression model was used to analyze the effect of hyperlipidemia on the incidence of cardio-cerebrovascular diseases in patients with type 2 diabetes. Results Diastolic blood pressure, systolic blood pressure, high-density lipoprotein, low-density lipoprotein, body mass index and hyper-sensitive C-reactive protein were higher in diabetes combined with hyperlipidemia group than in diabetes group (P < 0.05). At the end of the follow-up period, all-cause mortality, cardio-cerebrovascular diseases mortality, and the incidence of myocardial infarction, cerebral infarction, cerebral hemorrhage and total cardiovascular events were significantly higher in diabetes combined with hyperlipidemia group than in diabetes group (P < 0.05). The analysis results of multivariable Cox’s proportional hazards regression model showed that the risks of myocardial infarction and total cardiovascular events in diabetes combined with hyperlipidemia group were respectively 1.54 times (95%CI 1.13–2.07) and 1.68 times (95%CI 1.23–2.24) higher than those in diabetes group. Population attributable risk percent of all-cause mortality and total cardiovascular events in patients with type 2 diabetes combined with hyperlipidemia was 9.6% and 26.8%, respectively. Conclusions Hyperlipidemia may promote vascular endothelial injury, increasing the risk of cardio-cerebrovascular diseases in patients with type 2 diabetes. Medical staffs should pay attention to the control of blood lipids in patients with type 2 diabetes to delay the occurrence of cardio-cerebrovascular diseases.
Collapse
Affiliation(s)
- Dabei Fan
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Li Li
- Ophthalmologic Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhizhen Li
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ying Zhang
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaojun Ma
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lina Wu
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guijun Qin
- Division of Endocrinology Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
12
|
Cutiongco MFA, Chua BMX, Neo DJH, Rizwan M, Yim EKF. Functional differences between healthy and diabetic endothelial cells on topographical cues. Biomaterials 2018; 153:70-84. [PMID: 29125983 PMCID: PMC5724387 DOI: 10.1016/j.biomaterials.2017.10.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/04/2017] [Accepted: 10/20/2017] [Indexed: 12/23/2022]
Abstract
The endothelial lining of blood vessels is severely affected in type II diabetes. Yet, there is still a paucity on the use of diabetic endothelial cells for study and assessment of implantable devices targeting vascular disease. This critically impairs our ability to determine appropriate topographical cues to be included in implantable devices that can be used to maintain or improve endothelial cell function in vivo. Here, the functional responses of healthy and diabetic human coronary arterial endothelial cells were studied and observed to differ depending on topography. Gratings (2 μm) maintained normal endothelial functions such as adhesiveness, angiogenic capacity and cell-cell junction formation, and reduced immunogenicity of healthy cells. However, a significant and consistent effect was not observed in diabetic cells. Instead, diabetic endothelial cells cultured on the perpendicularly aligned multi-scale hierarchical gratings (250 nm gratings on 2 μm gratings) drastically reduced the uptake of oxidized low-density lipoprotein, decreased immune activation, and accelerated cell migration. Concave microlens (1.8 μm diameter) topography was additionally observed to overwhelmingly deteriorate diabetic endothelial cell function. The results of this study support a new paradigm and approach in the design and testing of implantable devices and biomedical interventions for diabetic patients.
Collapse
Affiliation(s)
- Marie F A Cutiongco
- Mechanobiology Institute, National University of Singapore, T-Lab, #10-01, 5A Engineering Drive 1, Singapore, 117411; Department of Biomedical Engineering, Block E4 #04-08, 4 Engineering Drive 3, National University of Singapore, 117583, Singapore
| | - Bryan M X Chua
- Department of Biomedical Engineering, Block E4 #04-08, 4 Engineering Drive 3, National University of Singapore, 117583, Singapore
| | - Dawn J H Neo
- Mechanobiology Institute, National University of Singapore, T-Lab, #10-01, 5A Engineering Drive 1, Singapore, 117411
| | - Muhammad Rizwan
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
| | - Evelyn K F Yim
- Mechanobiology Institute, National University of Singapore, T-Lab, #10-01, 5A Engineering Drive 1, Singapore, 117411; Department of Biomedical Engineering, Block E4 #04-08, 4 Engineering Drive 3, National University of Singapore, 117583, Singapore; Department of Surgery, National University of Singapore, Singapore; Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1.
| |
Collapse
|
13
|
Ismail M, Kabinejadian F, Nguyen YN, Tay Lik Wui E, Kim S, Leo HL. Hemodynamic assessment of extra-cardiac tricuspid valves using particle image velocimetry. Med Eng Phys 2017; 50:1-11. [DOI: 10.1016/j.medengphy.2017.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/04/2017] [Accepted: 08/07/2017] [Indexed: 11/29/2022]
|
14
|
Groot Jebbink E, Mathai V, Boersen JT, Sun C, Slump CH, Goverde PC, Versluis M, Reijnen MM. Hemodynamic comparison of stent configurations used for aortoiliac occlusive disease. J Vasc Surg 2017; 66:251-260.e1. [DOI: 10.1016/j.jvs.2016.07.128] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/27/2016] [Indexed: 10/20/2022]
|
15
|
Kumar GP, Kabinejadian F, Liu J, Ho P, Leo HL, Cui F. Simulated Bench Testing to Evaluate the Mechanical Performance of New Carotid Stents. Artif Organs 2016; 41:267-272. [PMID: 27357068 DOI: 10.1111/aor.12745] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/02/2016] [Accepted: 03/01/2016] [Indexed: 11/27/2022]
Abstract
Our group recently developed a novel covered carotid stent that can prevent emboli while preserving the external carotid artery (ECA) branch blood flow. However, our recent in vitro side-branch ECA flow preservation tests on the covered stents revealed the need for further stent frame design improvements, including the consideration to crimp the stent to a low profile for the delivery of the stent system and having bigger cells. Hence, the current work aims to design new bare metal stents with bigger cell size to improve the crimpability and to accommodate more slits so that the side-branch flow could be further increased. Three new stent designs were analyzed using finite element analysis and benchmarked against two commercially available carotid stents in terms of their mechanical performances such as crimpability, radial strength, and flexibility. Results indicated that the new bare metal stent designs matched well against the commercial stents. Hence our new generation covered stents based on these designs can be expected to perform better in side-branch flow preservation without compromising on their mechanical performances.
Collapse
Affiliation(s)
| | - Foad Kabinejadian
- Department of Bioengineering, National University of Singapore.,Department of Surgery, National University of Singapore
| | - Jianfei Liu
- Institute of High Performance Computing, A*STAR
| | - Pei Ho
- Department of Surgery, National University of Singapore.,Department of Cardiac, Thoracic & Vascular Surgery, National University Health System, Singapore
| | - Hwa Liang Leo
- Department of Bioengineering, National University of Singapore
| | - Fangsen Cui
- Institute of High Performance Computing, A*STAR
| |
Collapse
|
16
|
Kabinejadian F, Kaabi Nezhadian M, Cui F, Ho P, Leo HL. Covered Stent Membrane Design for Treatment of Atheroembolic Disease at Carotid Artery Bifurcation and Prevention of Thromboembolic Stroke: An In Vitro Experimental Study. Artif Organs 2015; 40:159-68. [DOI: 10.1111/aor.12520] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Foad Kabinejadian
- Department of Biomedical Engineering; National University of Singapore; Singapore Singapore
- Department of Surgery; National University of Singapore; Singapore Singapore
| | | | - Fangsen Cui
- Institute of High Performance Computing (IHPC); Agency for Science, Technology and Research (A*STAR); Singapore Singapore
| | - Pei Ho
- Department of Surgery; National University of Singapore; Singapore Singapore
- Department of Cardiac, Thoracic & Vascular Surgery; National University Health System; Singapore Singapore
| | - Hwa Liang Leo
- Department of Biomedical Engineering; National University of Singapore; Singapore Singapore
| |
Collapse
|
17
|
DOUTEL E, CARNEIRO J, OLIVEIRA MSN, CAMPOS JBLM, MIRANDA JM. FABRICATION OF 3D MILI-SCALE CHANNELS FOR HEMODYNAMIC STUDIES. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415500049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
3D mili-scale channel representing simplified anatomical models of blood vessels were constructed in polidimethylsiloxane (PDMS). The objective was to obtain a sequential method to fabricate transparent PDMS models from a mold produced by rapid prototyping. For this purpose, two types of casting methods were compared, a known lost-wax casting method and a casting method using sucrose. The channels fabricated by both casting methods were analyzed by Optical Microscopy, Scanning Electron Microscopy (SEM), and Energy Dispersive X-ray Spectroscopy (EDS). The lost-wax method is not ideal since the channels become contaminated during the removal process. The models produced with the lost-sucrose casting method exhibit much better optical characteristics. These models are transparent with no visible contamination, since the removing process is done by dissolution at room temperature rather than melting. They allow for good optical access for flow visualization and measurement of the velocity field by micro-Particle Image Velocimetry (μPIV). The channels fabricated by the lost-sucrose casting method were shown to be suitable for future hemodynamic studies using optical techniques.
Collapse
Affiliation(s)
- E. DOUTEL
- Centro de Estudos de Fenómenos de Transporte, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - J. CARNEIRO
- Centro de Estudos de Fenómenos de Transporte, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - M. S. N. OLIVEIRA
- Department of Mechanical and Aerospace Engineering, University of Strathclyde, Glasgow G1 1XJ, UK
| | - J. B. L. M. CAMPOS
- Centro de Estudos de Fenómenos de Transporte, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - J. M. MIRANDA
- Centro de Estudos de Fenómenos de Transporte, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| |
Collapse
|
18
|
Effects of a carotid covered stent with a novel membrane design on the blood flow regime and hemodynamic parameters distribution at the carotid artery bifurcation. Med Biol Eng Comput 2014; 53:165-77. [DOI: 10.1007/s11517-014-1222-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
|
19
|
Morr S, Lin N, Siddiqui AH. Carotid artery stenting: current and emerging options. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2014; 7:343-55. [PMID: 25349483 PMCID: PMC4208632 DOI: 10.2147/mder.s46044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Carotid artery stenting technologies are rapidly evolving. Options for endovascular surgeons and interventionists who treat occlusive carotid disease continue to expand. We here present an update and overview of carotid stenting devices. Evidence supporting carotid stenting includes randomized controlled trials that compare endovascular stenting to open surgical endarterectomy. Carotid technologies addressed include the carotid stents themselves as well as adjunct neuroprotective devices. Aspects of stent technology include bare-metal versus covered stents, stent tapering, and free-cell area. Drug-eluting and cutting balloon indications are described. Embolization protection options and new direct carotid access strategies are reviewed. Adjunct technologies, such as intravascular ultrasound imaging and risk stratification algorithms, are discussed. Bare-metal and covered stents provide unique advantages and disadvantages. Stent tapering may allow for a more fitted contour to the caliber decrement between the common carotid and internal carotid arteries but also introduces new technical challenges. Studies regarding free-cell area are conflicting with respect to benefits and associated risk; clinical relevance of associated adverse effects associated with either type is unclear. Embolization protection strategies include distal filter protection and flow reversal. Though flow reversal was initially met with some skepticism, it has gained wider acceptance and may provide the advantage of not crossing the carotid lesion before protection is established. New direct carotid access techniques address difficult anatomy and incorporate sophisticated flow-reversal embolization protection techniques. Carotid stenting is a new and exciting field with rapidly advancing technologies. Embolization protection, low-risk deployment, and lesion assessment and stratification are active areas of research. Ample room remains for further innovations and developments.
Collapse
Affiliation(s)
- Simon Morr
- Department of Neurosurgery, School of Medicine and Biomedical Sciences, Buffalo, NY, USA ; Department of Neurosurgery, Gates Vascular Institute, Kaleida Health, Buffalo, NY, USA
| | - Ning Lin
- Department of Neurosurgery, School of Medicine and Biomedical Sciences, Buffalo, NY, USA ; Department of Neurosurgery, Gates Vascular Institute, Kaleida Health, Buffalo, NY, USA
| | - Adnan H Siddiqui
- Department of Neurosurgery, School of Medicine and Biomedical Sciences, Buffalo, NY, USA ; Department of Radiology, School of Medicine and Biomedical Sciences, Buffalo, NY, USA ; Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, NY, USA ; Department of Neurosurgery, Gates Vascular Institute, Kaleida Health, Buffalo, NY, USA ; Jacobs Institute, Buffalo, NY, USA
| |
Collapse
|
20
|
Kabinejadian F, Ghista DN, Su B, Kaabi Nezhadian M, Chua LP, Yeo JH, Leo HL. In vitro measurements of velocity and wall shear stress in a novel sequential anastomotic graft design model under pulsatile flow conditions. Med Eng Phys 2014; 36:1233-45. [DOI: 10.1016/j.medengphy.2014.06.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 06/19/2014] [Accepted: 06/28/2014] [Indexed: 10/24/2022]
|