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Jo WI, Youn JH, Kang SY, Byeon DH, Lee HI, Yang HM, Park JK. Performance evaluation of biodegradable polymer sirolimus and ascorbic acid eluting stent systems. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:77. [PMID: 36308635 PMCID: PMC9617831 DOI: 10.1007/s10856-022-06699-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to evaluate the performance of biodegradable polymer sirolimus and ascorbic acid eluting stent systems with four commercially available drug-eluting stents (DES). We investigated the characterization of mechanical properties by dimension, foreshortening, recoil, radial force, crossing profile, folding shape, trackability, and dislodgement force. Additionally, we identify the safety and efficacy evaluation through registry experiments. Each foreshortening and recoil of D + Storm® DES is 1.3 and 3.70%, which has better performance than other products. A post-marketing clinical study to evaluate the performance and safety of D + Storm® DES is ongoing in real-world clinical settings. Two hundred one patients were enrolled in this study and have now completed follow-up for up to 1 month. No major adverse cardiovascular event (MACE) occurred in any subjects, confirming the safety of D + Storm® DES in the clinical setting. An additional approximately 100 subjects will be enrolled in the study and the final safety profile will be assessed in 300 patients. In conclusion, this study reported the objective evaluation of DES performance and compared the mechanical responses of four types of DES available in the market. There is little difference between the four cardiovascular stents in terms of mechanical features, and it can help choose the most suitable stent in a specific clinical situation if those features are understood. Graphical abstract.
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Affiliation(s)
| | | | | | | | | | - Hyoung-Mo Yang
- Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
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2
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Lewin TD, Avignon B, Tovaglieri A, Cabon L, Gjorevski N, Hutchinson LG. An in silico Model of T Cell Infiltration Dynamics Based on an Advanced in vitro System to Enhance Preclinical Decision Making in Cancer Immunotherapy. Front Pharmacol 2022; 13:837261. [PMID: 35586042 PMCID: PMC9108393 DOI: 10.3389/fphar.2022.837261] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/11/2022] [Indexed: 01/04/2023] Open
Abstract
Cancer immunotherapy often involves the use of engineered molecules to selectively bind and activate T cells located within tumour tissue. Fundamental to the success of such treatments is the presence or recruitment of T cells localised within the tumour microenvironment. Advanced organ-on-a-chip systems provide an in vitro setting in which to investigate how novel molecules influence the spatiotemporal dynamics of T cell infiltration into tissue, both in the context of anti-tumour efficacy and off-tumour toxicity. While highly promising, the complexity of these systems is such that mathematical modelling plays a crucial role in the quantitative evaluation of experimental results and maximising the mechanistic insight derived. We develop a mechanistic, mathematical model of a novel microphysiological in vitro platform that recapitulates T cell infiltration into epithelial tissue, which may be normal or transformed. The mathematical model describes the spatiotemporal dynamics of infiltrating T cells in response to chemotactic cytokine signalling. We integrate the model with dynamic imaging data to optimise key model parameters. The mathematical model demonstrates a good fit to the observed experimental data and accurately describes the distribution of infiltrating T cells. This model is designed to complement the in vitro system; with the potential to elucidate complex biological mechanisms, including the mode of action of novel therapies and the drivers of safety events, and, ultimately, improve the efficacy-safety profile of T cell-targeted cancer immunotherapies.
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Cheng J, Li J, Deng D, Wu G, Zhou M, Zhao G, Ni Z. Improved mechanical properties of poly(
l
‐lactic acid) stent coated by poly(
d
,
l
‐lactic acid) and poly(
l
‐lactic‐co‐glycolic acid) biopolymer blend. POLYM ADVAN TECHNOL 2021. [DOI: 10.1002/pat.5584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jie Cheng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Junjie Li
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Dongwen Deng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Gensheng Wu
- School of Mechanical and Electronic Engineering Nanjing Forestry University Nanjing China
| | - Min Zhou
- Department of Vascular Surgery The Affiliated Drum Tower Hospital, Nanjing University Medical School Nanjing China
| | - Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Zhonghua Ni
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
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Russ JB, Li RL, Herschman AR, Waisman H, Vedula V, Kysar JW, Kalfa D. Design optimization of a cardiovascular stent with application to a balloon expandable prosthetic heart valve. MATERIALS & DESIGN 2021; 209:109977. [PMID: 34366534 PMCID: PMC8336925 DOI: 10.1016/j.matdes.2021.109977] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A cardiovascular stent design optimization method is proposed with application to a pediatric balloon-expandable prosthetic heart valve. The prosthetic valved conduit may be expanded to a larger permanent diameter in vivo via subsequent transcatheter balloon dilation procedures. While multiple expandable prosthetic heart valves are currently at different stages of development, this work is focused on one particular design in which a stent is situated inside of an expandable polymeric valved conduit. Since the valve and conduit must be joined with a robust manufacturing technique, a polymeric glue layer is inserted between the two, which results in radial retraction of the valved region after expansion. Design of an appropriate stent is proposed to counteract this phenomenon and maintain the desired permanent diameter throughout the device after a single non-compliant balloon dilation procedure. The finite element method is used to compute performance metrics related to the permanent expansion diameter and required radial force. Additionally, failure due not only to high cycle fatigue but also due to ductile fracture is incorporated into the design study through the use of an existing ductile fracture criterion for metals. Surrogate models are constructed with the results of the high fidelity simulations and are subsequently used to numerically obtain a set of Pareto-optimal stent designs. Finally, a single design is identified by optimizing a normalized aggregate objective function with equal weighting of all design objectives.
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Affiliation(s)
- Jonathan B. Russ
- Columbia University, Department of Civil Engineering and Engineering Mechanics, New York, NY, USA
| | - Richard L. Li
- Columbia University, Department of Mechanical Engineering, New York, NY, USA
- Division of Cardiac, Thoracic and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, New-York Presbyterian - Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, NY, USA
| | - Abigail R. Herschman
- Columbia University, Department of Mechanical Engineering, New York, NY, USA
- Division of Cardiac, Thoracic and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, New-York Presbyterian - Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, NY, USA
| | - Haim Waisman
- Columbia University, Department of Civil Engineering and Engineering Mechanics, New York, NY, USA
| | - Vijay Vedula
- Columbia University, Department of Mechanical Engineering, New York, NY, USA
| | - Jeffrey W. Kysar
- Columbia University, Department of Mechanical Engineering, New York, NY, USA
- Department of Otolaryngology Head and Neck Surgery, Columbia University Medical Center, New York, NY, USA
| | - David Kalfa
- Division of Cardiac, Thoracic and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, New-York Presbyterian - Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, NY, USA
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5
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A computational optimization study of a self-expandable transcatheter aortic valve. Comput Biol Med 2021; 139:104942. [PMID: 34700254 DOI: 10.1016/j.compbiomed.2021.104942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 11/21/2022]
Abstract
Developing an efficient stent frame for transcatheter aortic valves (TAV) needs thorough investigation in different design and functional aspects. In recent years, most TAV studies have focused on their clinical performance, leaflet design, and durability. Although several optimization studies on peripheral stents exist, the TAV stents have different functional requirements and need to be explicitly studied. The aim of this study is to develop a cost-effective optimization framework to find the optimal TAV stent design made of Ni-Ti alloy. The proposed framework focuses on minimizing the maximum strain occurring in the stent during crimping, making use of a simplified model of the stent to reduce computational cost. The effect of the strut cross-section of the stent, i.e., width and thickness, and the number and geometry of the repeating units of the stent (both influencing the cell size) on the maximum strain is investigated. Three-dimensional simulations of the crimping process are used to verify the validity of the simplified representation of the stent, and the radial force has been calculated for further evaluation. The results suggest the key role of the number of cells (repeating units) and strut width on the maximum strain and, consequently, on the stent design. The difference in terms of the maximum strain between the simplified and the 3D model was less than 5%, confirming the validity of the adopted modeling strategy and the robustness of the framework to improve the TAV stent designs through a simple, cost-effective, and reliable procedure.
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Pan C, Han Y, Lu J. Structural Design of Vascular Stents: A Review. MICROMACHINES 2021; 12:mi12070770. [PMID: 34210099 PMCID: PMC8305143 DOI: 10.3390/mi12070770] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/16/2021] [Accepted: 06/24/2021] [Indexed: 11/18/2022]
Abstract
Percutaneous Coronary Intervention (PCI) is currently the most conventional and effective method for clinically treating cardiovascular diseases such as atherosclerosis. Stent implantation, as one of the ways of PCI in the treatment of coronary artery diseases, has become a hot spot in scientific research with more and more patients suffering from cardiovascular diseases. However, vascular stent implanted into vessels of patients often causes complications such as In-Stent Restenosis (ISR). The vascular stent is one of the sophisticated medical devices, a reasonable structure of stent can effectively reduce the complications. In this paper, we introduce the evolution, performance evaluation standards, delivery and deployment, and manufacturing methods of vascular stents. Based on a large number of literature pieces, this paper focuses on designing structures of vascular stents in terms of “bridge (or link)” type, representative volume unit (RVE)/representative unit cell (RUC), and patient-specific stent. Finally, this paper gives an outlook on the future development of designing vascular stents.
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Affiliation(s)
- Chen Pan
- School of Mechanical Engineering, Beijing Institute of Technology, Zhongguancun South Street No. 5, Haidian District, Beijing 100081, China; (C.P.); (J.L.)
- Institute of Engineering Medicine, Beijing Institute of Technology, Zhongguancun South Street No. 5, Haidian District, Beijing 100081, China
| | - Yafeng Han
- School of Mechanical Engineering, Beijing Institute of Technology, Zhongguancun South Street No. 5, Haidian District, Beijing 100081, China; (C.P.); (J.L.)
- Correspondence:
| | - Jiping Lu
- School of Mechanical Engineering, Beijing Institute of Technology, Zhongguancun South Street No. 5, Haidian District, Beijing 100081, China; (C.P.); (J.L.)
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Stevens JR, Zamani A, Osborne JIA, Zamani R, Akrami M. Critical evaluation of stents in coronary angioplasty: a systematic review. Biomed Eng Online 2021; 20:46. [PMID: 33964954 PMCID: PMC8105986 DOI: 10.1186/s12938-021-00883-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronary stents are routinely placed in the treatment and prophylaxis of coronary artery disease (CAD). Current coronary stent designs are prone to developing blockages: in-stent thrombosis (IST) and in-stent re-stenosis (ISR). This is a systematic review of the design of current coronary stent models, their structural properties and their modes of application, with a focus on their associated risks of IST and ISR. The primary aim of this review is to identify the best stent design features for reducing the risk of IST and ISR. To review the three major types of stents used in clinical settings today, determining best and relevant clinical practice by exploring which types and features of offer improved patient outcomes regarding coronary angioplasty. This information can potentially be used to increase the success rate of coronary angioplasty and stent technology in the future taking into account costs and benefits. METHODS Scientific databases were searched to find studies concerning stents. After the exclusion criteria were applied, 19 of the 3192 searched literature were included in this review. Studies investigating three major types of stent design were found: bare-metal stents (BMS), drug-eluting stents (DES) and bioresorbable stents (BRS). The number of participants varied between 14 and 1264. On average 77.4% were male, with a mean age of 64 years. RESULTS From the findings of these studies, it is clear that DES are superior in reducing the risk of ISR when compared to BMS. Conflicting results do not clarify whether BRS are superior to DES at reducing IST occurrence, although studies into newer BRS technologies show reducing events of IST to 0, creating a promising future for BRS showing them to be non-inferior. Thinner stents were shown to reduce IST rates, due to better re-endothelialisation. Scaffold material has also been shown to play a role with cobalt alloy stents reducing the risk of IST. This study found that thinner stents that release drugs were better at preventing re-blockages. Some dissolvable stents might be better at stopping blood clots blocking the arteries when compared to metal stents. The method and procedure of implanting the stent during coronary angioplasty influences success rate of these stents, meaning stent design is not the only significant factor to consider. CONCLUSIONS Positive developments in coronary angioplasty could be made by designing new stents that encompass all the most desirable properties of existing stent technology. Further work is needed to investigate the benefits of BRS in reducing the risk of IST compared to DES, as well as to investigate the effects of different scaffold materials on IST and ISR outcomes.
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Affiliation(s)
| | - Ava Zamani
- Medical School, University College London (UCL), London, UK
| | | | - Reza Zamani
- Medical School, College of Medicine and Health, Exeter, UK
| | - Mohammad Akrami
- Department of Mechanical Engineering, College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, UK.
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Xue H, Luo Z, Brown T, Beier S. Design of Self-Expanding Auxetic Stents Using Topology Optimization. Front Bioeng Biotechnol 2020; 8:736. [PMID: 32766219 PMCID: PMC7381139 DOI: 10.3389/fbioe.2020.00736] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 06/10/2020] [Indexed: 01/08/2023] Open
Abstract
Implanting stents is the most efficient and minimally invasive technique for treating coronary artery diseases, but the risks of stent thrombosis (ST) and in-stent restenosis (IRS) hamper the healing process. There have been a variety of stents in market but dominated by ad hoc design motifs. A systematic design method that can enhance deliverability, safety and efficacy is still in demand. Most existing designs are focused on patient and biological factors, while the mechanical failures related to stenting architectures, e.g., inadequate stent expansion, stent fracture, stent malapposition and foreshortening, are often underestimated. With regard to these issues, the self-expanding (SE) stents may perform better than balloon-expandable (BE) stents, but the SE stents are not popular in clinic practice due to poor deliverability, placement accuracy, and precise match of the stent size and shape to the vessel. This paper addresses the importance between stent structures and clinic outcomes in the treatment of coronary artery disease. First, a concurrent topological optimization method will be developed to systematically find the best material distribution within the design domain. An extended parametric level set method with shell elements is proposed in the topology optimization to ensure the accuracy and efficiency of computations. Second, the auxetic metamaterial with negative Poisson’s ratio is introduced into the self-expanding stents. Auxetics can enhance mechanical properties of structures, e.g., fracture toughness, indentation and shear resistance and vibration energy absorption, which will help resolve the drawbacks due to the mechanical failures. Final, the optimized SE stent is numerically validated with the commercial software ANSYS and then prototyped using additive manufacturing techniques. Topological optimization gives a rare opportunity to exploiting the unique advantages of additive manufacturing. Hence, the topologically optimized auxetic architectures will provide a new solution for developing novel stenting structures, especially conductive to self-expanding SE stents. The new design will overcome the limitations of conventional SE stents associated with mechanical structures while maintain their valuable features, to help reduce the occurrence of ST and ISR and benefit the clinic practice in treating coronary heart disease.
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Affiliation(s)
- Huipeng Xue
- School of Mechanical and Mechatronic Engineering, University of Technology Sydney, Ultimo, NSW, Australia
| | - Zhen Luo
- School of Mechanical and Mechatronic Engineering, University of Technology Sydney, Ultimo, NSW, Australia
| | - Terry Brown
- School of Mechanical and Mechatronic Engineering, University of Technology Sydney, Ultimo, NSW, Australia
| | - Susann Beier
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, NSW, Australia
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Degeling K, IJzerman MJ, Lavieri MS, Strong M, Koffijberg H. Introduction to Metamodeling for Reducing Computational Burden of Advanced Analyses with Health Economic Models: A Structured Overview of Metamodeling Methods in a 6-Step Application Process. Med Decis Making 2020; 40:348-363. [PMID: 32428428 PMCID: PMC7754830 DOI: 10.1177/0272989x20912233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/14/2020] [Indexed: 01/24/2023]
Abstract
Metamodels can be used to reduce the computational burden associated with computationally demanding analyses of simulation models, although applications within health economics are still scarce. Besides a lack of awareness of their potential within health economics, the absence of guidance on the conceivably complex and time-consuming process of developing and validating metamodels may contribute to their limited uptake. To address these issues, this article introduces metamodeling to the wider health economic audience and presents a process for applying metamodeling in this context, including suitable methods and directions for their selection and use. General (i.e., non-health economic specific) metamodeling literature, clinical prediction modeling literature, and a previously published literature review were exploited to consolidate a process and to identify candidate metamodeling methods. Methods were considered applicable to health economics if they are able to account for mixed (i.e., continuous and discrete) input parameters and continuous outcomes. Six steps were identified as relevant for applying metamodeling methods within health economics: 1) the identification of a suitable metamodeling technique, 2) simulation of data sets according to a design of experiments, 3) fitting of the metamodel, 4) assessment of metamodel performance, 5) conducting the required analysis using the metamodel, and 6) verification of the results. Different methods are discussed to support each step, including their characteristics, directions for use, key references, and relevant R and Python packages. To address challenges regarding metamodeling methods selection, a first guide was developed toward using metamodels to reduce the computational burden of analyses of health economic models. This guidance may increase applications of metamodeling in health economics, enabling increased use of state-of-the-art analyses (e.g., value of information analysis) with computationally burdensome simulation models.
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Affiliation(s)
- Koen Degeling
- />Health Technology and Services Research Department, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Overijssel, the Netherlands
- />Cancer Health Services Research Unit, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Maarten J. IJzerman
- />Victorian Comprehensive Cancer Centre, Melbourne, Australia
- />Health Technology and Services Research Department, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Overijssel, the Netherlands
- />Cancer Health Services Research Unit, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Mariel S. Lavieri
- Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Mark Strong
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, England, UK
| | - Hendrik Koffijberg
- Health Technology and Services Research Department, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, Overijssel, the Netherlands
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10
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Song K, Bi Y, Zhao H, Wu T, Xu F, Zhao G. Structural optimization and finite element analysis of poly‐
l
‐lactide acid coronary stent with improved radial strength and acute recoil rate. J Biomed Mater Res B Appl Biomater 2020; 108:2754-2764. [DOI: 10.1002/jbm.b.34605] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/02/2020] [Accepted: 03/01/2020] [Indexed: 02/02/2023]
Affiliation(s)
- Kai Song
- Key Laboratory for Liquid‐Solid Structural Evolution and Processing of Materials (Ministry of Education), School of Materials Science and Engineering Shandong University Jinan China
| | - Yuying Bi
- Dongguan TT Medical Inc. Guangdong China
- Biomedical Engineering and Biotechnology University of Massachusetts Lowell Massachusetts
| | - Haibin Zhao
- Key Laboratory for Liquid‐Solid Structural Evolution and Processing of Materials (Ministry of Education), School of Materials Science and Engineering Shandong University Jinan China
- Shenzhen Research Institute of Shandong University, Shenzhen Guangdong China
| | - Tim Wu
- Dongguan TT Medical Inc. Guangdong China
- Biomedical Engineering and Biotechnology University of Massachusetts Lowell Massachusetts
| | - Feng Xu
- Department of Emergency Medicine, Qilu Hospital, Shandong University Jinan China
| | - Guoqun Zhao
- Key Laboratory for Liquid‐Solid Structural Evolution and Processing of Materials (Ministry of Education), School of Materials Science and Engineering Shandong University Jinan China
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11
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Rocatello G, De Santis G, De Bock S, De Beule M, Segers P, Mortier P. Optimization of a Transcatheter Heart Valve Frame Using Patient-Specific Computer Simulation. Cardiovasc Eng Technol 2019; 10:456-468. [PMID: 31197702 DOI: 10.1007/s13239-019-00420-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 06/07/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE This study proposes a new framework to optimize the design of a transcatheter aortic valve through patient-specific finite element and fluid dynamics simulation. METHODS Two geometrical parameters of the frame, the diameter at ventricular inflow and the height of the first row of cells, were examined using the central composite design. The effect of those parameters on postoperative complications was investigated by response surface methodology, and a Nonlinear Programming by Quadratic Lagrangian algorithm was used in the optimization. Optimal and initial devices were then compared in 12 patients. The comparison was made in terms of device performance [i.e., reduced contact pressure on the atrioventricular conduction system and paravalvular aortic regurgitation (AR)]. RESULTS Results suggest that large diameters and high cells favor higher anchoring of the device within the aortic root reducing the contact pressure and favor a better apposition of the device to the aortic root preventing AR. Compared to the initial device, the optimal device resulted in almost threefold lower predicted contact pressure and limited AR in all patients. CONCLUSIONS In conclusion, patient-specific modelling and simulation could help to evaluate device performance prior to the actual first-in-human clinical study and, combined with device optimization, could help to develop better devices in a shorter period.
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Affiliation(s)
| | | | - Sander De Bock
- FEops NV, Technologiepark-Zwijnaarde 122, 9052, Ghent, Belgium
| | | | | | - Peter Mortier
- FEops NV, Technologiepark-Zwijnaarde 122, 9052, Ghent, Belgium.
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Degeling K, IJzerman M, Koffijberg H. A scoping review of metamodeling applications and opportunities for advanced health economic analyses. Expert Rev Pharmacoecon Outcomes Res 2018; 19:181-187. [DOI: 10.1080/14737167.2019.1548279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- K. Degeling
- Health Technology and Services Research Department, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - M.J. IJzerman
- Health Technology and Services Research Department, Technical Medical Centre, University of Twente, Enschede, the Netherlands
- Cancer Health Services Research Unit, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - H. Koffijberg
- Health Technology and Services Research Department, Technical Medical Centre, University of Twente, Enschede, the Netherlands
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13
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Putra NK, Palar PS, Anzai H, Shimoyama K, Ohta M. Multiobjective design optimization of stent geometry with wall deformation for triangular and rectangular struts. Med Biol Eng Comput 2018; 57:15-26. [DOI: 10.1007/s11517-018-1864-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/18/2018] [Indexed: 12/26/2022]
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14
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Tang D, Li ZY. Preface: Computational and experimental methods for biological research: cardiovascular diseases and beyond. Biomed Eng Online 2016; 15:157. [PMID: 28155696 PMCID: PMC5259905 DOI: 10.1186/s12938-016-0269-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Dalin Tang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096 China
- Department of Mathematical Sciences, Worcester Polytechnic Institute, Worcester, MA 01609 USA
| | - Zhi-Yong Li
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096 China
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