1
|
Allum Saib Z, Abed F, Ghayesh MH, Amabili M. Interaction of a self-expandable stent with the arterial wall in the presence of hypocellular and calcified plaques. Biomech Model Mechanobiol 2024:10.1007/s10237-024-01896-6. [PMID: 39369168 DOI: 10.1007/s10237-024-01896-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 09/25/2024] [Indexed: 10/07/2024]
Abstract
Self-expandable stents manufactured from nitinol alloys are commonly utilized alongside traditional balloon-expandable stents to provide scaffolding to stenosed arteries. However, a significant limitation hampering stent efficacy is restenosis, triggered by neointimal hyperplasia and resulting in the loss of gain in lumen size, post-intervention. In this study, a nonlinear finite element model was developed to simulate stent crimping and expansion and its interaction with the surrounding vessel in the presence of a plaque. The main aim was to determine contact pressures and forces induced at the interface between an artery wall with hypocellular and calcified plaques and an expanded stent. The results demonstrated the drawbacks of plaque calcification, which triggered a sharp contact pressure and radial force surge at the interface as well as a significant rise in von Mises stress within the vessel, potentially leading to rupture and restenosis. A regression line was then established to relate hypocellular and calcified plaques. The adjusted coefficient of determination indicated a good correlation between contact pressures for calcified and hypocellular plaque models. Regarding the directionality of wall properties, contact pressure and force observations were not significantly different between isotropic and anisotropic arteries. Moreover, variations in friction coefficients did not substantially affect the interfacial contact pressures.
Collapse
Affiliation(s)
- Zubeir Allum Saib
- Biomedical Engineering Graduate Program, American University of Sharjah, P.O. Box 26666, Sharjah, United Arab Emirates
| | - Farid Abed
- Department of Civil Engineering, American University of Sharjah, P.O. Box 26666, Sharjah, United Arab Emirates.
| | - Mergen H Ghayesh
- School of Electrical and Mechanical Engineering, University of Adelaide, Adelaide, South Australia, Australia
| | - Marco Amabili
- School of Engineering, Westlake University, Zhejiang Province, Hangzhou, People's Republic of China
- Department of Mechanical Engineering, McGill University, Montreal, Canada
| |
Collapse
|
2
|
Umeh CA, Stratton A, Wagner T, Saigal S, Sood K, Dhawan R, Wagner C, Obi J, Kumar S, Ching THS, Gupta R. Use of intravascular lithotripsy in non-coronary artery lesions. World J Cardiol 2023; 15:395-405. [PMID: 37771339 PMCID: PMC10523193 DOI: 10.4330/wjc.v15.i8.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 06/25/2023] [Accepted: 07/24/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Intravascular lithotripsy (IVL) is a novel technique increasingly used for plaque modification and endovascular revascularization in patients with severe calcification and peripheral artery disease. However, much of the available literature on IVL is focused on its use in coronary arteries, with relatively limited data on non-coronary artery use. AIM To analyze the safety and efficacy of current IVL use in non-coronary artery lesions, as reported in case reports and case series. METHODS We searched EMBASE, PubMed, and Reference Citation Analysis databases for case reports and case series on IVL use in peripheral artery disease. We then extracted variables of interest and calculated the mean and proportions of these variables. RESULTS We included 60 patients from 33 case reports/case series. Ninety-eight percent of the cases had IVL usage in only one blood vessel, while four had the IVL used in two vessels (2.0%), resulting in 64 Lesions treated with IVL. The mean age of the patients was 73.7 (SD 10.9). IVL was successfully used in severe iliofemoral artery stenosis (51.6%), severe innominate, subclavian, and carotid artery stenosis (26.7% combined), and severe mesenteric vessel stenosis (9.4%). Additionally, IVL was successfully used in severe renal (7.8%) and aortic artery (4.7%) stenosis. There were complications in 12% of the cases, with dissection being the commonest. CONCLUSION IVL has successfully used in plaque modification and endovascular revascularization in severely calcified and challenging lesions in the iliofemoral, carotid, subclavian, aorta, renal, and mesenteric vessels. The most severe but transient complications were with IVL use in the aortic arch and neck arteries.
Collapse
Affiliation(s)
| | - Ashley Stratton
- Internal Medicine, Hemet Global Medical Center, Hemet, CA 92543, United States
| | - Tifani Wagner
- Internal Medicine, Hemet Global Medical Center, Hemet, CA 92543, United States
| | - Shipra Saigal
- Internal Medicine, Hemet Global Medical Center, Hemet, CA 92543, United States
| | - Krystal Sood
- Internal Medicine, Hemet Global Medical Center, Hemet, CA 92543, United States
| | - Raghav Dhawan
- Internal Medicine, Hemet Global Medical Center, Hemet, CA 92543, United States
| | - Cory Wagner
- Internal Medicine, Hemet Global Medical Center, Hemet, CA 92543, United States
| | - Jessica Obi
- Internal Medicine, Hemet Global Medical Center, Hemet, CA 92543, United States
| | - Sabina Kumar
- Department of Cardiology, Mclaren Macomb-Oakland/Michigan State University, Macomb, MI 48043, United States
| | | | - Rahul Gupta
- Internal Medicine, University of California, San Diego, CA 92122, United States
| |
Collapse
|
3
|
Khan MS, Baig M, Moustafa A, Saraswat A, Kwok M, Kazimuddin M, Hyder ON, Aronow HD, Soukas PA. Intravascular lithotripsy in calcified subclavian and innominate peripheral artery disease: A single centre experience. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2021; 40:37-41. [PMID: 34872849 DOI: 10.1016/j.carrev.2021.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/13/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Intravascular lithotripsy (IVL) is a novel tool for the treatment of calcified vascular stenosis. Recently, IVL has been successfully used for modification of calcified plaque in coronary and lower extremity peripheral arteries with promising results. However, experience in subclavian and innominate peripheral arterial disease is limited. This study aims to report our initial experience of IVL use in calcified subclavian and innominate vasculature. METHODS This was a retrospective review of all the cases of IVL performed in subclavian and innominate arteries at the Miriam Hospital, Providence, between January 2019 and May 2020. Data on the baseline and procedural characteristics were collected. The primary endpoint was procedural success defined as residual stenosis of <20% after stenting. Other endpoints of interest were; 1) procedural complications, including dissections, perforations, abrupt closure, slow or no-reflow, thrombosis, and distal embolization; 2) in-hospital major adverse cardiac events (MACE) defined as a composite of death, myocardial infarction, or stroke/transient ischemic attack. RESULTS A total of 7 patients with 13 lesions undergoing IVL were included. Of these, 5 (71%) were women, the mean age was 74.6 ± 12.9, and the mean BMI was 25.1 ± 6.7. IVL was successfully delivered to all the target lesions with a mean 252.9 ± 54.4 pulses delivered per patient. Procedural success was achieved in 100% of the treated lesions. No procedure-related complications or in-hospital MACE occurred in any of the patients. CONCLUSIONS In this single-center retrospective analysis, IVL facilitated acute procedural success without any procedural complications in severely calcified stenoses of the subclavian and innominate vasculature. Larger studies with an active comparator and longer follow-up are needed to establish the relative efficacy and safety of IVL use in this vascular bed.
Collapse
Affiliation(s)
- Mohammad Saud Khan
- Division of Cardiology, Western Kentucky Heart and Lung and Med Center Health, Bowling Green, KY, United States of America; Department of Medicine, University of Kentucky at Bowling Green, Bowling Green, KY, United States of America
| | - Muhammad Baig
- Division of Cardiology, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Abdelmoniem Moustafa
- Division of Cardiology, University of Toledo Medical Center, Toledo, OH, United States of America
| | - Arti Saraswat
- Department of Medicine, University of Kentucky at Bowling Green, Bowling Green, KY, United States of America
| | - Michael Kwok
- Department of Medicine, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Mohammed Kazimuddin
- Division of Cardiology, Western Kentucky Heart and Lung and Med Center Health, Bowling Green, KY, United States of America; Department of Medicine, University of Kentucky at Bowling Green, Bowling Green, KY, United States of America
| | - Omar N Hyder
- Division of Cardiology, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Herbert D Aronow
- Division of Cardiology, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Peter A Soukas
- Division of Cardiology, Alpert Medical School of Brown University, Providence, RI, United States of America.
| |
Collapse
|
4
|
Study on the Correlation Factors of Tumour Prognosis after Intravascular Interventional Therapy. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6940056. [PMID: 34745508 PMCID: PMC8566042 DOI: 10.1155/2021/6940056] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 12/18/2022]
Abstract
Noninvasive or minimally invasive interventional surgery was selected, and the complications were less and had no significant impact on the quality of life of patients. Tumour patients are often accompanied by cerebrovascular diseases, metabolic diseases, and other basic diseases, which more or less adversely affect the surgical efficacy of tumour. In this paper, endovascular remobilization was used to treat tumour; the basic condition of patients before operation and the interventional operation plan were introduced. Through the analysis of clinical data and prognosis evaluation results of tumour patients receiving intravascular interventional therapy, the patients were divided into good prognosis group and poor prognosis group according to the modified Rankin scale score at discharge. The relationship between gender, age, history of hypertension, tumour width, tumour size, preoperative Hunt-Hess grade, interventional surgery method, and prognosis related to intravascular interventional therapy was explored. The results showed that intravascular interventional therapy for tumour patients can obtain a good prognosis, which provides a reference for the future preoperative assessment of treatment risk and possible prognosis and provides a theoretical basis for the formulation of treatment plan to improve prognosis.
Collapse
|
5
|
Khalid N, Case BC, Ahmad SA, Kayani WT. Intravascular Lithotripsy-Facilitated Carotid Interventions. J Endovasc Ther 2021; 28:486. [PMID: 33475029 DOI: 10.1177/1526602821989355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nauman Khalid
- Section of Interventional Cardiology, Saint Francis Medical Center, Monroe, LA, USA
| | - Brian C Case
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Sarah Aftab Ahmad
- Section of Cardiothoracic Surgery, Saint Francis Medical Center, Monroe, LA, USA
| | - Waleed Tallat Kayani
- Section of Interventional Cardiology, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
6
|
Kassimis G, Banning AP. Reply to the Letter to the Editor Entitled "Intravascular Lithotripsy Facilitated Cardiovascular Interventions". Angiology 2020; 72:98. [PMID: 33021101 DOI: 10.1177/0003319720963603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- George Kassimis
- 2nd Cardiology Department, 69200Aristotle University of Thessaloniki, Hippokration Hospital, Greece.,1st Cardiology Department, AHEPA General Hospital, 69200Aristotle University of Thessaloniki, Greece
| | - Adrian P Banning
- Oxford Heart Centre, 11269John Radcliffe Hospital, Oxford, United Kingdom
| |
Collapse
|
7
|
Butt N, Arshid A, Javed H, Kayani WT, Ahmad SA, Khalid N. Intravascular Lithotripsy Facilitated Cardiovascular Interventions. Angiology 2020; 72:97. [PMID: 32911953 DOI: 10.1177/0003319720956484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Nausharwan Butt
- Section of Internal Medicine, 8405MedStar Washington Hospital Center, Washington, DC, USA
| | - Awais Arshid
- 473270Ayub Teaching Hospital, Ayub Medical College, Abbottabad, Pakistan
| | - Hasan Javed
- Section of Cardiology, 8405MedStar Washington Hospital Center, Washington, DC, USA
| | - Waleed Tallat Kayani
- Section of Interventional Cardiology, 3989Baylor College of Medicine, Houston, TX, USA
| | - Sarah Aftab Ahmad
- Section of Cardiothoracic Surgery, St. Francis Medical Center, Monroe, LA, USA
| | - Nauman Khalid
- Section of Interventional Cardiology, St. Francis Medical Center, Monroe, LA, USA
| |
Collapse
|