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Liu H, Liu Y, Ip BYM, Ma SH, Abrigo J, Soo YOY, Leung TW, Leng X. Effects of stent shape on focal hemodynamics in intracranial atherosclerotic stenosis: A simulation study with computational fluid dynamics modeling. Front Neurol 2022; 13:1067566. [PMID: 36582612 PMCID: PMC9792661 DOI: 10.3389/fneur.2022.1067566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
Background and aims The shape of a stent could influence focal hemodynamics and subsequently plaque growth or in-stent restenosis in intracranial atherosclerotic stenosis (ICAS). In this preliminary study, we aim to investigate the associations between stent shapes and focal hemodynamics in ICAS, using computational fluid dynamics (CFD) simulations with manually manipulated stents of different shapes. Methods We built an idealized artery model, and reconstructed four patient-specific models of ICAS. In each model, three variations of stent geometry (i.e., enlarged, inner-narrowed, and outer-narrowed) were developed. We performed static CFD simulation on the idealized model and three patient-specific models, and transient CFD simulation of three cardiac cycles on one patient-specific model. Pressure, wall shear stress (WSS), and low-density lipoprotein (LDL) filtration rate were quantified in the CFD models, and compared between models with an inner- or outer-narrowed stent vs. an enlarged stent. The absolute difference in each hemodynamic parameter was obtained by subtracting values from two models; a normalized difference (ND) was calculated as the ratio of the absolute difference and the value in the enlarged stent model, both area-averaged throughout the arterial wall. Results The differences in focal pressure in models with different stent geometry were negligible (ND<1% for all cases). However, there were significant differences in the WSS and LDL filtration rate with different stent geometry, with ND >20% in a static model. Observable differences in WSS and LDL filtration rate mainly appeared in area adjacent to and immediately distal to the stent. In the transient simulation, the LDL filtration rate had milder temporal fluctuations than WSS. Conclusions The stent geometry might influence the focal WSS and LDL filtration rate in ICAS, with negligible effect on pressure. Future studies are warranted to verify the relevance of the changes in these hemodynamic parameters in governing plaque growth and possibly in-stent restenosis in ICAS.
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Affiliation(s)
- Haipeng Liu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Yu Liu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Bonaventure Y. M. Ip
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sze Ho Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jill Abrigo
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yannie O. Y. Soo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Thomas W. Leung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xinyi Leng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Xinyi Leng
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Cao T, Jiang Z, Zhao H, Zhang KQ, Meng K. Numerical simulation to study the impact of compliance mismatch between artificial and host blood vessel on hemodynamics. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Sarkar DJ, Bera AK, Baitha R, Das BK. Synthesis optimization of PEG diblock copolymer-based nanoemulsion of cypermethrin through central composite design and bioefficacy evaluation against fish ectoparasite Argulus bengalensis. CHEMICAL PAPERS 2022. [DOI: 10.1007/s11696-022-02369-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Liu S, Jin Y, Wang X, Zhang Y, Jiang L, Li G, Zhao X, Jiang T. Increased Carotid Siphon Tortuosity Is a Risk Factor for Paraclinoid Aneurysms. Front Neurol 2022; 13:869459. [PMID: 35620791 PMCID: PMC9127410 DOI: 10.3389/fneur.2022.869459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Geometrical factors associated with the surrounding vasculature can affect the risk of aneurysm formation. The aim of this study was to determine the association between carotid siphon curvature and the formation and development of paraclinoid aneurysms of the internal carotid artery. Methods Digital subtraction angiography (DSA) data from 42 patients with paraclinoid aneurysms (31 with non-aneurysmal contralateral sides) and 42 age- and gender-matched healthy controls were analyzed, retrospectively. Morphological characteristics of the carotid siphon [the posterior angle (α), anterior angle (β), and Clinoid@Ophthalmic angle (γ)] were explored via three-dimensional rotational angiography (3D RA) multiplanar reconstruction. The association between carotid siphon morphology and the formation of paraclinoid aneurysms was assessed through univariate analysis. After this, logistic regression analysis was performed to identify independent risk factors for aneurysms. Results Significantly smaller α, β, and γ angles were reported in the aneurysmal carotid siphon group when compared with the non-aneurysmal contralateral healthy controls. The β angle was best for discriminating between aneurysmal and non-aneurysmal carotid siphons, with an optimal threshold of 18.25°. By adjusting for hypertension, smoking habit, hyperlipidemia, and diabetes mellitus, logistic regression analysis demonstrated an independent association between the carotid siphons angles α [odds ratio (OR) 0.953; P < 0.05], β (OR 0.690; P < 0.001), and γ (OR 0.958; P < 0.01) with the risk of paraclinoid aneurysms. Conclusions The present findings provide evidence for the importance of morphological carotid siphon variations and the likelihood of paraclinoid aneurysms. These practical morphological parameters specific to paraclinoid aneurysms are easy to assess and may aid in risk assessment in these patients.
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Affiliation(s)
- Shilin Liu
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yu Jin
- Department of Neurology, Bozhou City Peoples Hospital, Bozhou, China
| | - Xukou Wang
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yang Zhang
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Luwei Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guanqing Li
- Department of Neurology, Bozhou City Peoples Hospital, Bozhou, China
| | - Xi Zhao
- Philips Healthcare China, Shanghai, China
| | - Tao Jiang
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
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Ameenuddin M, Anand M. A Mixture Theory Model for Blood Combined With Low-Density Lipoprotein Transport to Predict Early Atherosclerosis Regions in Idealized and Patient-Derived Abdominal Aorta. J Biomech Eng 2020; 142:101008. [PMID: 32507886 DOI: 10.1115/1.4047426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Indexed: 07/25/2024]
Abstract
Genesis and onset of atherosclerosis are greatly influenced by hemodynamic forces. Two-phase transient computational fluid dynamic (CFD) simulations are performed using a mixture theory model for blood, and a transport equation for low-density lipoprotein (LDL), in idealized and patient-derived abdominal aorta to predict the sites at risk for atherosclerosis. Flow patterns at different time instants and relevant hemodynamic indicators-wall shear stress (WSS)-based (time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT)), and LDL concentration-are used concurrently to predict the susceptible sites of atherosclerosis. In the case of idealized geometry, flow recirculations are observed on the posterior wall opposite the superior mesenteric artery and below the renal bifurcations. Low TAWSS, high OSI, high RRT and high concentration of LDL are observed in these regions. This suggests that in idealized abdominal aorta, the posterior wall proximal to the renal artery junction is more prone to atherosclerosis. This matches qualitatively with the experimental and simulation data in the literature. In the case of patient-derived geometry, flow reversal, low TAWSS, high OSI and high RRT are observed infrarenal on the anterior wall. Further, high concentration of LDL is observed at the same location on the anterior wall suggesting anterior wall distal to the renal artery junction is more prone to atherosclerosis. These findings demonstrate the use of a novel method to predict the sites at risk for atherosclerosis in geometries where complexities like junctions and curvature play a major role.
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Affiliation(s)
- Mohammed Ameenuddin
- Department of Chemical Engineering, Indian Institute of Technology Hyderabad, Sangareddy, Telangana 502285, India
| | - Mohan Anand
- Department of Chemical Engineering, Indian Institute of Technology Hyderabad, Sangareddy, Telangana 502285, India
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Bortot M, Sharifi A, Ashworth K, Walker F, Cox A, Ruegg K, Clendenen N, Neeves KB, Bark D, Di Paola J. Pathologic Shear and Elongation Rates Do Not Cause Cleavage of Von Willebrand Factor by ADAMTS13 in a Purified System. Cell Mol Bioeng 2020; 13:379-390. [PMID: 32952737 PMCID: PMC7479076 DOI: 10.1007/s12195-020-00631-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 06/18/2020] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Pathological flows in patients with severe aortic stenosis are associated with acquired von Willebrand syndrome. This syndrome is characterized by excessive cleavage of von Willebrand factor by its main protease, A Disintegrin and Metalloproteinase with a Thrombospondin Type 1 Motif, Member 13 (ADAMTS13) leading to decreased VWF function and mucocutaneous bleeding. Aortic valve replacement and correction of the flow behavior to physiological levels reverses the syndrome, supporting the association between pathological flow and acquired von Willebrand syndrome. We investigated the effects of shear and elongational rates on von Willebrand factor cleavage in the presence of ADAMTS13. METHODS We identified acquired von Willebrand syndrome in five patients with severe aortic stenosis. Doppler echography values from these patients were used to develop three computational fluid dynamic (CFD) aortic valve models (normal, mild and severe stenosis). Shear, elongational rates and exposure times identified in the CFD simulations were used as parameters for the design of microfluidic devices to test the effects of pathologic shear and elongational rates on the structure and function of von Willebrand factor. RESULTS The shear rates (0-10,000s-1), elongational rates (0-1000 s-1) and exposure times (1-180 ms) tested in our microfluidic designs mimicked the flow features identified in patients with aortic stenosis. The shear and elongational rates tested in vitro did not lead to excessive cleavage or decreased function of von Willebrand factor in the presence of the protease. CONCLUSIONS High shear and elongational rates in the presence of ADAMTS13 are not sufficient for excessive cleavage of von Willebrand Factor.
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Affiliation(s)
- Maria Bortot
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
- Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Alireza Sharifi
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523 USA
| | - Katrina Ashworth
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Faye Walker
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Allaura Cox
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Katherine Ruegg
- Hemophilia Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Nathan Clendenen
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
| | - Keith B. Neeves
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
- Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
| | - David Bark
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523 USA
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523 USA
| | - Jorge Di Paola
- Department of Pediatrics, Washington University in St. Louis, 660 S. Euclid Avenue, Campus Box 8208, 5th floor MPRB, St. Louis, MO 63110 USA
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Liu H, Gong Y, Leng X, Xia L, Wong KS, Ou S, Leung TW, Wang D, Shi L. Estimating current and long-term risks of coronary artery in silico by fractional flow reserve, wall shear stress and low-density lipoprotein filtration rate. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aa9a09] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chen S, Adepu M, Emady H, Jiao Y, Gel A. Enhancing the physical modeling capability of open-source MFIX-DEM software for handling particle size polydispersity: Implementation and validation. POWDER TECHNOL 2017. [DOI: 10.1016/j.powtec.2017.04.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ameenuddin M, Anand M. Effect of angulation and Reynolds number on recirculation at the abdominal aorta-renal artery junction. Artery Res 2017. [DOI: 10.1016/j.artres.2017.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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