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Hosseinzadeh E, Bosques-Palomo B, Carmona-Arriaga F, Fabiani MA, Aguirre-Soto A. Fabrication of Soft Transparent Patient-Specific Vascular Models with Stereolithographic 3D printing and Thiol-Based Photopolymerizable Coatings. Macromol Rapid Commun 2024; 45:e2300611. [PMID: 38158746 DOI: 10.1002/marc.202300611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/03/2023] [Indexed: 01/03/2024]
Abstract
An ideal vascular phantom should be anatomically accurate, have mechanical properties as close as possible to the tissue, and be sufficiently transparent for ease of visualization. However, materials that enable the convergence of these characteristics have remained elusive. The fabrication of patient-specific vascular phantoms with high anatomical fidelity, optical transparency, and mechanical properties close to those of vascular tissue is reported. These final properties are achieved by 3D printing patient-specific vascular models with commercial elastomeric acrylic-based resins before coating them with thiol-based photopolymerizable resins. Ternary thiol-ene-acrylate chemistry is found optimal. A PETMP/allyl glycerol ether (AGE)/polyethylene glycol diacrylate (PEGDA) coating with a 30/70% AGE/PEGDA ratio applied on a flexible resin yielded elastic modulus, UTS, and elongation of 3.41 MPa, 1.76 MPa, and 63.2%, respectively, in range with the human aortic wall. The PETMP/AGE/PEGDA coating doubled the optical transmission from 40% to 80%, approaching 88% of the benchmark silicone-based elastomer. Higher transparency correlates with a decrease in surface roughness from 2000 to 90 nm after coating. Coated 3D-printed anatomical replicas are showcased for pre-procedural planning and medical training with good radio-opacity and echogenicity. Thiol-click chemistry coatings, as a surface treatment for elastomeric stereolithographic 3D-printed objects, address inherent limitations of photopolymer-based additive manufacturing.
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Affiliation(s)
- Elnaz Hosseinzadeh
- School of Engineering and Sciences, Tecnologico de Monterrey, Nuevo León, Monterrey, 64849, México
| | - Beatriz Bosques-Palomo
- School of Engineering and Sciences, Tecnologico de Monterrey, Nuevo León, Monterrey, 64849, México
| | | | - Mario Alejandro Fabiani
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Nuevo León, Monterrey, 64710, México
| | - Alan Aguirre-Soto
- School of Engineering and Sciences, Tecnologico de Monterrey, Nuevo León, Monterrey, 64849, México
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2
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Lu K, Qin W, Sun X, Si Y, Ding G, Fu W, Wang S. Computational study of fenestration and parallel grafts used in TEVAR of aortic arch aneurysms. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3664. [PMID: 36447341 DOI: 10.1002/cnm.3664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/16/2022] [Accepted: 11/26/2022] [Indexed: 06/16/2023]
Abstract
To explore the differences between fenestration technique and parallel grafts technique of thoracic endovascular aortic repair, and evaluate the risk of complications after interventional treatment of aortic arch aneurysms. A three-dimensional aortic model was established from the follow-up imaging data of patient who reconstructed the superior arch vessel by the chimney technique, which was called the chimney model. Based on the chimney model, the geometric of the reconstructed vessel was modified by virtual surgery, and the normal model, fenestration model and periscope model were established. The blood flow waveforms measured by 2D phase contrast magnetic resonance imaging were processed as the boundary conditions of the ascending aorta inlet and the superior arch vessels outlets of the normal model. The pressure waveform of descending aorta was obtained using three-element Windkessel model, and specific pressure boundary conditions were imposed at reconstructed branches for the postoperative models. Through computational fluid dynamics simulations, the hemodynamic parameters of each model were obtained. The reconstructed vessel flow rate of the periscope model and the fenestration model are 33% and 50% of that of the normal model, respectively. The pressure difference between the inner and outer walls of the fenestration stent and periscope stent is 3.15 times and 7.56 times that of the chimney stent. The velocity in the fenestration stent and periscope stent is uneven. The high relative residence time is concentrated in the region around the branch stents, which is prone to thrombosis. The "gutter" part of the chimney model may become larger due to the effect of the stent-graft DF, increasing the risk of endoleak. For patients with incomplete circle of Willis, the periscope technique to reconstruct the supra-arch vessels may affect blood perfusion. It is recommended to use balloon-expandable stent for fenestration stent and periscope stent, and self-expanding stent for chimney stent. For patients with aortic arch aneurysms, the fenestration technique may be superior to the parallel grafts technique.
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Affiliation(s)
- Kai Lu
- Department of Aeronautics and Astronautics, Institute of Biomechanics, Fudan University, Shanghai, China
| | - Wang Qin
- Department of Aeronautics and Astronautics, Institute of Biomechanics, Fudan University, Shanghai, China
| | - Xiaofan Sun
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yi Si
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guanghong Ding
- Department of Aeronautics and Astronautics, Institute of Biomechanics, Fudan University, Shanghai, China
- Shanghai Key Laboratory for Acupuncture Mechanism and Acupoint Function, Fudan University, Shanghai, China
| | - Weiguo Fu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shengzhang Wang
- Department of Aeronautics and Astronautics, Institute of Biomechanics, Fudan University, Shanghai, China
- Institute of Biomedical Engineering Technology, Academy of Engineering and Technology, Fudan University, Shanghai, China
- Yiwu Research Institute, Fudan University, Yiwu, China
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Bianchi D, Conti M, Bissacco D, Domanin M, Trimarchi S, Auricchio F. Impact of thoracic endovascular aortic repair on aortic biomechanics: Integration of in silico and ex vivo analysis using porcine model. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3594. [PMID: 35340129 DOI: 10.1002/cnm.3594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/09/2022] [Accepted: 03/16/2022] [Indexed: 05/12/2023]
Abstract
Thoracic endovascular aortic repair (TEVAR) is widespread in clinical practice for treating aortic diseases but it has relevant systemic complications, such as increase of the cardiac workload due to post-TEVAR aortic stiffening, and local issues such as re-entry tears due to the tissue damage caused by endograft interaction. The present study aims to elucidate these aortic biomechanical mechanisms by coupling ex vivo and in silico analysis. By ex vivo tests, the pulse wave velocity before and after TEVAR is measured. Uni-axial tensile tests are performed to measure regional mechanical response of tissue samples, supplied as input data for the in silico analysis. Numerical analysis is finally performed to compute the wall stress induced by the stent-graft deployment and the arterial pressurization. The ex vivo results highlight an increase of baseline PWV by a mean .78 m/s or 12% after TEVAR with a 100 mm stent-graft (p <.013). In the in silico analysis, the average von Mises stress in the landing zone increases of about 15% and 20% using, respectively stent-graft with radial oversizing of 10% and 20%. This work shows the effectiveness of integrated framework to analyze the biomechanical post TEVAR mechanisms. Moreover, the obtained results quantify the effect of prosthesis selection on the stiffening of the aorta after TEVAR and on the local increase of the aortic wall stress that is proportional to the stent-graft oversizing.
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Affiliation(s)
- Daniele Bianchi
- Department of Civil Engineering and Architecture (DICAr), University of Pavia, Pavia, Italy
| | - Michele Conti
- Department of Civil Engineering and Architecture (DICAr), University of Pavia, Pavia, Italy
| | - Daniele Bissacco
- Department of Health and Community Sciences, University of Milan, Milan, Italy
- Operative Unit of Vascular Surgery, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Maurizio Domanin
- Department of Health and Community Sciences, University of Milan, Milan, Italy
- Operative Unit of Vascular Surgery, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Santi Trimarchi
- Department of Health and Community Sciences, University of Milan, Milan, Italy
- Operative Unit of Vascular Surgery, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Ferdinando Auricchio
- Department of Civil Engineering and Architecture (DICAr), University of Pavia, Pavia, Italy
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Patient-Specific Image-Based Computational Fluid Dynamics Analysis of Abdominal Aorta and Branches. J Pers Med 2022; 12:jpm12091502. [PMID: 36143287 PMCID: PMC9503755 DOI: 10.3390/jpm12091502] [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: 08/13/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
The complicated abdominal aorta and its branches are a portion of the circulatory system prone to developing atherosclerotic plaque and aneurysms. These disorders are closely connected to the changing blood flow environment that the area’s complicated architecture produces (between celiac artery and iliac artery bifurcation); this phenomenon is widespread at arterial bifurcations. Based on computed tomography angiography (CTA) scans, this current work offers a numerical analysis of a patient-specific reconstruction of the abdominal aorta and its branches to identify and emphasize the most likely areas to develop atherosclerosis. The simulations were run following the heart cycle and under physiological settings. The wall shear stress (WSS), velocity field, and streamlines were examined. According to the findings, complex flow is primarily present at the location of arterial bifurcations, where abnormal flow patterns create recirculation zones with low and fluctuating WSS (<0.5 Pa), which are known to affect endothelial homeostasis and cause adverse vessel remodeling. The study provides a patient-specific hemodynamic analysis model, which couples in vivo CT imaging with in silico simulation under physiological circumstances. The study offers quantitative data on the range fluctuations of important hemodynamic parameters, such as WSS and recirculation region expansion, which are directly linked to the onset and progression of atherosclerosis. The findings could also help drug targeting at this vascular level by understanding blood flow patterns in the abdominal aorta and its branches.
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Liu D, Wang X, Zhao D, Sun Z, Biekan J, Wen Z, Xu L, Liu J. Influence of MRI-based boundary conditions on type B aortic dissection simulations in false lumen with or without abdominal aorta involvement. Front Physiol 2022; 13:977275. [PMID: 36160847 PMCID: PMC9490059 DOI: 10.3389/fphys.2022.977275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Most computational hemodynamic studies of aortic dissections rely on idealized or general boundary conditions. However, numerical simulations that ignore the characteristics of the abdominal branch arteries may not be conducive to accurately observing the hemodynamic changes below the branch arteries. In the present study, two men (M-I and M-II) with type B aortic dissection (TBAD) underwent arterial-phase computed tomography angiography and four-dimensional flow magnetic resonance imaging (MRI) before and after thoracic endovascular aortic repair (TEVAR). The finite element method was used to simulate the computational fluid dynamic parameters of TBAD [false lumen (FL) with or without visceral artery involvement] under MRI-specific and three idealized boundary conditions in one cardiac cycle. Compared to the results of zero pressure and outflow boundary conditions, the simulations with MRI boundary conditions were closer to the initial MRI data. The pressure difference between true lumen and FL after TEVAR under the other three boundary conditions was lower than that of the MRI-specific results. The results of the outflow boundary conditions could not characterize the effect of the increased wall pressure near the left renal artery caused by the impact of Tear-1, which raised concerns about the distal organ and limb perfused by FL. After TEVAR, the flow velocity and wall pressure in the FL and the distribution areas of high time average wall shear stress and oscillating shear index were reduced. The difference between the calculation results for different boundary conditions was lower in M-II, wherein FL did not involve the abdominal aorta branches than in M-I. The boundary conditions of the abdominal branch arteries from MRI data might be valuable in elucidating the hemodynamic changes of the descending aorta in TBAD patients before and after treatment, especially those with FL involving the branch arteries.
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Affiliation(s)
- Dongting Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xuan Wang
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Dongliang Zhao
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, WA, Australia
- *Correspondence: Jiayi Liu, ; Zhonghua Sun,
| | | | - Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- *Correspondence: Jiayi Liu, ; Zhonghua Sun,
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Kimura N, Nakamura M, Takagi R, Mieno MN, Yamaguchi A, Czerny M, Beyersdorf F, Kari FA, Rylski B. False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection. Interact Cardiovasc Thorac Surg 2022; 35:6585342. [PMID: 35552699 PMCID: PMC9486891 DOI: 10.1093/icvts/ivac138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
OBJECTIVES
We aimed to determine whether non-A non-B aortic dissection (AD) differs in morphologic and haemodynamic properties from type B AD.
METHODS
We simulated and compared haemodynamics of patients with acute type B or acute non-A non-B AD by means of computational fluid dynamics. Wall pressure and wall shear stress (WSS) in both the true lumen (TL) and false lumen (FL) at early, mid- and late systole were evaluated. Morphology, WSS and the FL/TL wall pressure ratio were compared between groups.
RESULTS
Nineteen patients (type B, n = 7; non-A non-B, n = 12) were included. The median age (51 [46, 67] vs 53 [50, 63] years; P = 0.71) and a complicated course (14% vs 33%; P = 0.6) did not differ between the type B group and the non-A non-B group. However, the median entry tear width was increased in the non-A non-B group (9.7 [7.3, 12.7] vs 16.3 [11.9, 24.9] mm; P = 0.010). Streamlines showed, in patients with non-A non-B AD, blood from the TL flowed into the FL via the entry tear. Prevalence of a FL/TL wall pressure ratio >1.0 (type B versus non-A non-B) at early, mid- and late systole was 57% vs 83% (P = 0.31), 43% vs 83% (P = 0.13) and 57% vs 75% (P = 0.62), respectively. WSS did not differ between the groups.
CONCLUSIONS
The increased FL/TL wall pressure ratio observed during systole in non-A non-B AD may beget a complicated presentation.
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Affiliation(s)
- Naoyuki Kimura
- Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University , Saitama, Japan
| | - Masanori Nakamura
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology , Nagoya, Japan
| | - Reiya Takagi
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology , Nagoya, Japan
| | - Makiko Naka Mieno
- Department of Medical Informatics, Center for Information, Jichi Medical University , Shimotsuke, Japan
| | - Atsushi Yamaguchi
- Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University , Saitama, Japan
| | - Martin Czerny
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University of Freiburg , Freiburg, Germany
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University of Freiburg , Freiburg, Germany
| | - Fabian Alexander Kari
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University of Freiburg , Freiburg, Germany
| | - Bartosz Rylski
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University of Freiburg , Freiburg, Germany
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Wang D, Zhang H, Du L, Zhai Q, Hu G, Gao W, Zhang A, Wang S, Hao Y, Shang K, Liu X, Gao Y, Muyesai N, Ma Q. Early Prediction Model of Acute Aortic Syndrome Mortality in Emergency Departments. Int J Gen Med 2022; 15:3779-3788. [PMID: 35418773 PMCID: PMC8995175 DOI: 10.2147/ijgm.s357910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose Acute aortic syndrome is a constellation of life-threatening medical conditions for which rapid assessment and targeted intervention are important for the prognosis of patients who are at high risk of in-hospital death. The current study aims to develop and externally validate an early prediction mortality model that can be used to identify high-risk patients with acute aortic syndrome in the emergency department. Patients and Methods This retrospective multi-center observational study enrolled 1088 patients with acute aortic syndrome admitted to the emergency departments of two hospitals in China between January 2017 and March 2021 for model development. A total of 210 patients with acute aortic syndrome admitted to the emergency departments of Peking University Third Hospital between January 2007 and December 2021 was enrolled for model validation. Demographics and clinical factors were collected at the time of emergency department admission. The predictive variables were determined by referring to the results of previous studies and the baseline analysis of this study. The study’s endpoint was in-hospital death. To assess internal validity, we used a fivefold cross-validation method. Model performance was validated internally and externally by evaluating model discrimination using the area under the receiver-operating characteristic curve (AUC). A nomogram was developed based on the binary regression results. Results In the development cohort, 1088 patients with acute aortic syndromes were included, and 88 (8.1%) patients died during hospitalization. In the validation cohort, 210 patients were included, and 20 (9.5%) patients died during hospitalization. The final model included the following variables: digestive system symptoms (OR=2.25; P=0.024), any pulse deficit (OR=7.78; P<0.001), creatinine (µmol/L)(OR=1.00; P=0.018), lesion extension to iliac vessels (OR=4.49; P<0.001), pericardial effusion (OR=2.67; P=0.008), and Stanford type A (OR=10.46; P<0.001). The model’s AUC was 0.838 (95% CI 0.784–0.892) in the development cohort and 0.821 (95% CI 0.750–0.891) in the validation cohort, and the Hosmer–Lemeshow test showed p=0.597. The fivefold cross-validation demonstrated a mean accuracy of 0.94, a mean precision of 0.67, and a mean recall of 0.13. Conclusion This risk prediction tool uses simple variables to provide robust prediction of the risk of in-hospital death from acute aortic syndrome and validated well in an independent cohort. The tool can help emergency clinicians quickly identify high-risk acute aortic syndrome patients, although further studies are needed for verifying the prospective data and the results of our study.
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Affiliation(s)
- Daidai Wang
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Lanfang Du
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Qiangrong Zhai
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Guangliang Hu
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Wei Gao
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Anyi Zhang
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Sa Wang
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Yajuan Hao
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Kaijian Shang
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
- Department of Emergency Medicine, Second hospital of Shanxi Medical University, Shanxi, People’s Republic of China
| | - Xueqing Liu
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Yanxia Gao
- Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Nijiati Muyesai
- Department of Emergency Medicine, Xinjiang Ulger Municipal People’s Hospital, Urumqi, People’s Republic of China
| | - Qingbian Ma
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
- Correspondence: Qingbian Ma; Nijiati Muyesai, Tel +86 15611908229, Email ;
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Yin M, Ban E, Rego BV, Zhang E, Cavinato C, Humphrey JD, Em Karniadakis G. Simulating progressive intramural damage leading to aortic dissection using DeepONet: an operator-regression neural network. J R Soc Interface 2022; 19:20210670. [PMID: 35135299 PMCID: PMC8826120 DOI: 10.1098/rsif.2021.0670] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/23/2021] [Indexed: 12/28/2022] Open
Abstract
Aortic dissection progresses mainly via delamination of the medial layer of the wall. Notwithstanding the complexity of this process, insight has been gleaned by studying in vitro and in silico the progression of dissection driven by quasi-static pressurization of the intramural space by fluid injection, which demonstrates that the differential propensity of dissection along the aorta can be affected by spatial distributions of structurally significant interlamellar struts that connect adjacent elastic lamellae. In particular, diverse histological microstructures may lead to differential mechanical behaviour during dissection, including the pressure-volume relationship of the injected fluid and the displacement field between adjacent lamellae. In this study, we develop a data-driven surrogate model of the delamination process for differential strut distributions using DeepONet, a new operator-regression neural network. This surrogate model is trained to predict the pressure-volume curve of the injected fluid and the damage progression within the wall given a spatial distribution of struts, with in silico data generated using a phase-field finite-element model. The results show that DeepONet can provide accurate predictions for diverse strut distributions, indicating that this composite branch-trunk neural network can effectively extract the underlying functional relationship between distinctive microstructures and their mechanical properties. More broadly, DeepONet can facilitate surrogate model-based analyses to quantify biological variability, improve inverse design and predict mechanical properties based on multi-modality experimental data.
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Affiliation(s)
- Minglang Yin
- Center for Biomedical Engineering, Brown University, Providence, RI 02912, USA
- School of Engineering, Brown University, Providence, RI 02912, USA
| | - Ehsan Ban
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Bruno V. Rego
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Enrui Zhang
- Division of Applied Mathematics, Brown University, Providence, RI 02912, USA
| | - Cristina Cavinato
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Jay D. Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - George Em Karniadakis
- School of Engineering, Brown University, Providence, RI 02912, USA
- Division of Applied Mathematics, Brown University, Providence, RI 02912, USA
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Peng Y, Zhang X, Li J, Zhang X, He H, Li X, Fang K, Zheng L, Shu C. Enlarged Lumen Volume of Proximal Aortic Segment and Acute Type B Aortic Dissection: A Computer Fluid Dynamics Study of Ideal Aortic Models. Int J Gen Med 2022; 15:535-543. [PMID: 35046712 PMCID: PMC8763263 DOI: 10.2147/ijgm.s343403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background Recent study has revealed that enlarged diameters of the ascending aorta and proximal aortic arch enhance the probability of ATBAD. However, little is understood about the relation to ATBAD. Objective This study explored the differences in proximal aortic segment (PAS) morphology in patients with acute type B aortic dissection (ATBAD), and performed hemodynamic simulations to provide proof of principle. Materials and Methods The morphological characteristics of PAS in the ATBAD group (n = 163) and corresponding segment in the control group (n = 120) were retrospectively measured. The morphological parameters were analyzed using comprehensive statistical approaches. Ridge regression analysis was also performed to determine the association between independent variable and dependent variable. P < 0.01 was considered significant. Idealized aortic models were established based on variables of statistical significance, and hemodynamic simulations were performed to evaluate blood flow changes caused by morphology. Results Diameters at landmarks of PAS were significantly larger in the ATBAD group. The lumen volume (VPAS) of PAS in the ATBAD group was significantly enlarged than that of the control group (124,659.07 ± 34,089.27 mm3 vs 89,796.65 ± 30,334.40 mm3; P < 0.001). Furthermore, the VPAS was positively correlated to diameters. As the VPAS increased, the fluid kinetic energy in PAS enhanced linearly, and time-averaged wall shear stress and oscillatory shear index at the distal area of the left subclavian artery increased significantly. Conclusion In the ATBAD group, the enlarged VPAS and increased diameters of PAS are positively correlated. Meanwhile, the enlarged VPAS leads to more aggressive hemodynamic parameters at the distal area of the left subclavian artery, which may create a contributory condition for ATBAD.
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Affiliation(s)
- Yuan Peng
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China
| | - Xuelan Zhang
- School of Mathematics and Physics, University of Science and Technology Beijing, Beijing, 100083, People’s Republic of China
| | - Jiehua Li
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China
| | - Xiaolong Zhang
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China
| | - Hao He
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China
| | - Xin Li
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China
| | - Kun Fang
- Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100037, People’s Republic of China
| | - Liancun Zheng
- School of Mathematics and Physics, University of Science and Technology Beijing, Beijing, 100083, People’s Republic of China
| | - Chang Shu
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China
- Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100037, People’s Republic of China
- Correspondence: Chang Shu Tel +86-731-85295832 Email
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10
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Yan L, Qi X, Han X, Wang J, He F. Study on the Flow State of Circulating Cooling Water for the Industrial Heat Exchange Tube in the Electromagnetic Anti-Fouling Process. ACS OMEGA 2021; 6:28515-28527. [PMID: 34746547 PMCID: PMC8567286 DOI: 10.1021/acsomega.1c02193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
Comparing with the traditional chemical and physical method, the electromagnetic water treatment technology draws more attention of researchers for its advantages of easy application, small investment, low cost, and being pollution free in recent years. However, due to the less study of the formation process and adhesion of fouling on the surface of heat exchange equipment, the electromagnetic anti-fouling performance cannot be well evaluated. This paper studies the numerical simulation of the flow states of circulating cooling water in heat exchange tubes with a straight shape and U-shaped ones and analyzes the experimental data of fouling resistance on heat transfer surface under the action of 0.5, 0.75, 1, and 1.5 kHz electromagnetic fields. The variations in the velocity field and pressure field at various points in heat exchange tubes declare that the velocity of the circulating cooling water is smaller in the outlet of the pipeline. The change of the circulating cooling water flow state with the pipeline shape causes a certain impact on fluid velocity, and the pressure value at the outlet is larger. It is obtained that the flow velocity in the area with high surface pressure of circulating cooling water is relatively small. The experimental results indicate that the fouling resistance on the surface of the magnetic heat exchange tube is smaller than that of the nonmagnetic one. The anti-fouling efficiency in 0.5, 0.75, 1, and 1.5 kHz magnetic and contrast experiments are 46.8, 84.8, 91.2, and 63.6%, respectively. Better anti-fouling performances are obtained under the action of about 1 kHz electromagnetic frequency. The induction period of fouling on the heat exchange surface is lengthened under electromagnetic fields. All these studies are of significant importance to further understand the formation process and adhesion of fouling on the surface of heat exchange equipment, as well as to better evaluate the electromagnetic anti-fouling performance.
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Affiliation(s)
- Lei Yan
- School
of Technology, Beijing Forestry University, Beijing 100083, China
| | - Xiao Qi
- Energy
and Electricity Research Center, Jinan University, Zhuhai 519070, China
| | - Xing Han
- Chip
Development Center, Beijing Zhixin Microelectronics
Technology Co., Ltd, Beijing 102200, China
| | - Jianguo Wang
- School
of Automation Engineering, Northeast Electric
Power University, Jilin 132012, China
| | - Fang He
- School
of Technology, Beijing Forestry University, Beijing 100083, China
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11
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HOU XIAOXI, OU CHUBIN, HANZAWA KAZUHIKO, DAI XILEI, QIAN YI. GUIDANCE ON AREA OF CREATED TEARS FOR AORTIC FENESTRATION TREATMENT BASED ON COMPUTATIONAL FLUID DYNAMICS. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421500378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aortic fenestration (AF) uses puncture and a dilation balloon to create a tear in the intimal flap, which can directly relieve ischemia syndrome and reduce hypertension in the false lumen. The selection of a dilation balloon as well as the area of the created tear applied in reality depend on clinical experience, so we aim to provide a quantitative guidance and reference for doctors to better plan the treatment of aortic fenestration. In this study, the area of the created tear was virtually enlarged to at least 10 different values for four cases including one ideal case, and a computational fluid dynamic approach was applied to simulate blood flows in the aorta. The area ratio (AR) between the created tear and entry tear was introduced to express the enlargement of the created tear. The quantitative hemodynamic results indicate that the AR should be controlled to be larger than 7.0, but not too big to obtain the best treatment for acute aortic dissection (AD) case. Additionally, we assessed that AR might also be a risk factor for the prediction of dissection propagation.
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Affiliation(s)
- XIAOXI HOU
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia 75 Talavera Road, Macquarie Park NSW, 2113, Australia
| | - CHUBIN OU
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia 75 Talavera Road, Macquarie Park NSW, 2113, Australia
| | - KAZUHIKO HANZAWA
- Advanced Treatment and Prevention for Vascular Disease and Embolism, Niigata University, Graduate School of Medicine, 1-757, Asahimachi-dori, Niigata City, 951-8511, Japan
| | - XILEI DAI
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia 75 Talavera Road, Macquarie Park NSW, 2113, Australia
| | - YI QIAN
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia 75 Talavera Road, Macquarie Park NSW, 2113, Australia
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12
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Effect of Geometric Accuracy at the Proximal Landing Zone on Simulation Results for Thoracic Endovascular Repair Patients. Cardiovasc Eng Technol 2020; 11:679-688. [PMID: 33145725 DOI: 10.1007/s13239-020-00498-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/20/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE Existing hemodynamic studies on aortic dissection after thoracic endovascular aortic repair (TEVAR) apply geometric simplifications. This study aims to evaluate the necessity of more accurate geometries at the proximal landing zone in computational fluid dynamic (CFD) studies. METHODS Three patient-specific 3D aortic dissection models with different geometric accuracies at the proximal landing zone were manually fabricated for CFD simulations: (i) model 1 without the stent graft (SG), (ii) model 2 with the metal stent, and (iii) model 3 with the SG. The flow distribution, flow pattern, and wall shear stress (WSS)-related indicators in these three models were compared. RESULTS The flow distributions were quite similar for the three models, with a maximum absolute difference of 0.27% at the left suclavian artery (LSA) between models 1 and 3 because of partial coverage. A more chaotic flow pattern was observed at the proximal landing zone in model 3, with significant regional differences in the WSS-related indicator distributions. The upstream and downstream WSS-related indicator distributions were quite similar for the three models. CONCLUSIONS The flow pattern and hemodynamic parameter distributions were affected by the geometric accuracy only in a small region near the proximal landing zone. The flow split was hardly affected by the LSA partial coverage, indicating that the coverage may have slight effects on short-term blood perfusion. However, this conclusion needs to be verified in future studies with larger sample sizes.
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13
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Spatial Configuration of Abdominal Aortic Aneurysm Analysis as a Useful Tool for the Estimation of Stent-Graft Migration. Diagnostics (Basel) 2020; 10:diagnostics10100737. [PMID: 32977588 PMCID: PMC7598279 DOI: 10.3390/diagnostics10100737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/11/2020] [Accepted: 09/21/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to prepare a self-made mathematical algorithm for the estimation of risk of stent-graft migration with the use of data on abdominal aortic aneurysm (AAA) size and geometry of blood flow through aneurysm sac before or after stent-graft implantation. AngioCT data from 20 patients aged 50–60 years, before and after stent-graft placement in the AAA was analyzed. In order to estimate the risk of stent-graft migration for each patient we prepared an opposite spatial configuration of virtually reconstructed stent-graft with long body or short body. Thus, three groups of 3D geometries were analyzed: 20 geometries representing 3D models of aneurysm, 20 geometries representing 3D models of long body stent-grafts, and 20 geometries representing 3D models of short body stent-graft. The proposed self-made algorithm demonstrated its efficiency and usefulness in estimating wall shear stress (WSS) values. Comparison of the long or short type of stent-graft with AAA geometries allowed to analyze the implants’ spatial configuration. Our study indicated that short stent-graft, after placement in the AAA sac, generated lower drug forces compare to the long stent-graft. Each time shape factor was higher for short stent-graft compare to long stent-graft.
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14
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Cebull HL, Rayz VL, Goergen CJ. Recent Advances in Biomechanical Characterization of Thoracic Aortic Aneurysms. Front Cardiovasc Med 2020; 7:75. [PMID: 32478096 PMCID: PMC7235347 DOI: 10.3389/fcvm.2020.00075] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/14/2020] [Indexed: 12/18/2022] Open
Abstract
Thoracic aortic aneurysm (TAA) is a focal enlargement of the thoracic aorta, but the etiology of this disease is not fully understood. Previous work suggests that various genetic syndromes, congenital defects such as bicuspid aortic valve, hypertension, and age are associated with TAA formation. Though occurrence of TAAs is rare, they can be life-threatening when dissection or rupture occurs. Prevention of these adverse events often requires surgical intervention through full aortic root replacement or implantation of endovascular stent grafts. Currently, aneurysm diameters and expansion rates are used to determine if intervention is warranted. Unfortunately, this approach oversimplifies the complex aortopathy. Improving treatment of TAAs will likely require an increased understanding of the biological and biomechanical factors contributing to the disease. Past studies have substantially contributed to our knowledge of TAAs using various ex vivo, in vivo, and computational methods to biomechanically characterize the thoracic aorta. However, any singular approach typically focuses on only material properties of the aortic wall, intra-aneurysmal hemodynamics, or in vivo vessel dynamics, neglecting combinatorial factors that influence aneurysm development and progression. In this review, we briefly summarize the current understanding of TAA causes, treatment, and progression, before discussing recent advances in biomechanical studies of TAAs and possible future directions. We identify the need for comprehensive approaches that combine multiple characterization methods to study the mechanisms contributing to focal weakening and rupture. We hope this summary and analysis will inspire future studies leading to improved prediction of thoracic aneurysm progression and rupture, improving patient diagnoses and outcomes.
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Affiliation(s)
- Hannah L Cebull
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Vitaliy L Rayz
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States.,Purdue Center for Cancer Research, Purdue University, West Lafayette, IN, United States
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15
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Shape and Enhancement Analysis as a Useful Tool for the Presentation of Blood Hemodynamic Properties in the Area of Aortic Dissection. J Clin Med 2020; 9:jcm9051330. [PMID: 32370301 PMCID: PMC7290319 DOI: 10.3390/jcm9051330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/19/2020] [Accepted: 04/28/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to create a mathematical approach for blood hemodynamic description with the use of brightness analysis. Medical data was collected from three male patients aged from 45 to 65 years with acute type IIIb aortic dissection that started proximal to the left subclavian artery and involved the renal arteries. For the recognition of wall dissection areas Digital Imaging and Communications in Medicine (DICOM) data were applied. The distance from descending aorta to the diaphragm was analyzed. Each time Feret (DF) and Hydraulic (DHy) diameter were calculated. Moreover, an average brightness (BAV) was analyzed. Finally, to describe blood hemodynamic in the area of aortic wall dissection, mathematical function combining difference in brightness value and diameter for each computed tomography (CT) scan was calculated. The results indicated that DF described common duct more accurately compare to DHy. While, DHy described more accurately true and false ducts. Each time when connection of true and false duct appeared, true duct had lower brightness compare to common duct and false duct. Moreover, false duct characterized with higher brightness compare to common duct. In summary, the proposed algorithm mimics changes in brightness value for patients with acute type IIIb aortic dissection.
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16
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Hwaung P, Heo M, Bourgeois B, Kennedy S, Shepherd J, Heymsfield SB. Greater Height Is Associated with a Larger Carotid Lumen Diameter. MEDICINES 2019; 6:medicines6020057. [PMID: 31091706 PMCID: PMC6631842 DOI: 10.3390/medicines6020057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 11/16/2022]
Abstract
Background: Previous studies link tall stature with a reduced ischemic stroke risk. One theory posits that tall people have larger cerebral artery lumens and therefore have a lower plaque occlusion risk than those who are short. Previous studies have not critically evaluated the associations between height and cerebral artery structure independent of confounding factors. Methods: The hypothesis linking stature with cerebral artery lumen size was tested in 231 adults by measuring the associations between height and common carotid artery diameter (CCAD) and intima-media thickness (IMT) after controlling for recognized vascular influencing factors (e.g., adiposity, blood pressure, plasma lipids, etc.). Results: Height remained a significant CCAD predictor across all developed multiple regression models. These models predict a ~0.03 mm increase in CCAD for each 1-cm increase in height in this sample. This magnitude of CCAD increase with height represents over a 60% enlargement of the artery's lumen area across adults varying in stature from short (150 cm) to tall (200 cm). By contrast, IMT was non-significantly correlated with height across all developed regression models. Conclusions: People who are tall have a larger absolute CCAD than people who are short, while IMT is independent of stature. These observations potentially add to the growing cardiovascular literature aimed at explaining the lower risk of ischemic strokes in tall people.
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Affiliation(s)
- Phoenix Hwaung
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
| | - Brianna Bourgeois
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
| | - Samantha Kennedy
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA.
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
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Computational Evaluation for Age-Dependent Material Nonlinear Behavior of Aortic Wall Tissue on Abdominal Aortic Aneurysms. APPLIED SCIENCES-BASEL 2018. [DOI: 10.3390/app9010101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An abdominal aortic aneurysm is a localized expansion of the abdominal aorta with a diameter >3 cm or >50% larger than the normal diameter. In this study, the stretch and strength of the materials in the abdominal aorta in patients with aneurysms were examined based on the results of tensile tests, and databases of failure stress and stretch were established according to age. Generally, the tensile test results of the axial and circumferential directions have become a priority in the tests of aortic materials. However, this study focused on the results of the axial direction. In addition, finite element analysis, where the Holzapfel model and the test results were applied, was performed. As a result, the behavior characteristics of the abdominal aortic materials were precisely simulated. The formula and material constants used in the Holzapfel model were studied and proposed in order to simulate the failure stress and stretch according to age as well as simulation.
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