Morphological and hemodynamical alterations in brachial artery and cephalic vein. An image‐based study for preoperative assessment for vascular access creation

The current study aims to computationally evaluate the effect of right upper arm position on the geometric and hemodynamic characteristics of the brachial artery (BA) and cephalic vein (CV) and, furthermore, to present in detail the methodology to characterise morphological and hemodynamical healthy vessels. Ten healthy volunteers were analysed in two configurations, the supine (S) and the prone (P) position. Lumen 3D surface models were constructed from images acquired from a non-contrast MRI sequence. Then, the models were used to numerically compute the physiological range of geometric (n = 10) and hemodynamic (n = 3) parameters in the BA and CV. Geometric parameters such as curvature and tortuosity, and hemodynamic parameters based on wall shear stress (WSS) metrics were calculated with the use of computational fluid dynamics. Our results highlight that changes in arm position had a greater impact on WSS metrics of the BA by altering the mean and maximum blood flow rate of the vessel. Whereas, curvature and tortuosity were found not to be significantly different between positions. Inter-variability was associated with antegrade and retrograde flow in BA, and antegrade flow in CV. Shear stress was low and oscillatory shear forces were negligible. This data suggests that deviations from this state may contribute to the risk of accelerated intimal hyperplasia of the vein in arteriovenous fistulas. Therefore, preoperative conditions coupled with post-operative longitudinal data will aid the identification of such relationships

Transient Cardiovascular Hemodynamics In A Patient-Specific Arterial System

The ultimate goal of the present study is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present study a full cardiovascular experimental phantom and digital phantom (CFD model) was fabricated to study: (1) the effects of local hemodynamics on global hemodynamics, (2) the effects of transition from bed-rest to upright position, and (3) transport of dye (drug delivery) in the arterial system. Computational three dimensional (3-D) models (designs A, B, and C) stents were also developed to study the effects of stent design on hemodynamic flow and the effects of drug deposition into the arterial wall. The experimental phantom used in the present study is the first system reported in literature to be used for hemodynamic assessment in static and orthostatic posture changes. Both the digital and experimental phantom proved to provide different magnitudes of wall shear and normal stresses in sections where previous studies have only analyzed single arteries. The dye mass concentration study for the digital and experimental cardiovascular phantom proved to be useful as a surrogate for medical drug dispersion. The dye mass concentration provided information such as transition time and drug trajectory paths. For the stent design CFD studies, hemodynamic results (wall shear stress (WSS), normal stress, and vorticity) were assessed to determine if simplified stented geometries can be used as a surrogate for patient-specific geometries and the role of stent design on flow. Substantial differences in hemodynamic parameters were found to exist which confirms the need for patient-specific modeling. For drug eluting stent studies, the total deposition time for the drug into the arterial wall was approximately 3.5 months

Shear-promoted drug encapsulation into red blood cells: a CFD model and μ-PIV analysis

The present work focuses on the main parameters that influence shear-promoted encapsulation of drugs into erythrocytes. A CFD model was built to investigate the fluid dynamics of a suspension of particles flowing in a commercial micro channel. Micro Particle Image Velocimetry (μ-PIV) allowed to take into account for the real properties of the red blood cell (RBC), thus having a deeper understanding of the process. Coupling these results with an analytical diffusion model, suitable working conditions were defined for different values of haematocrit

Book of Abstracts 15th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering and 3rd Conference on Imaging and Visualization

In this edition, the two events will run together as a single conference, highlighting the strong connection with the Taylor & Francis journals: Computer Methods in Biomechanics and Biomedical Engineering (John Middleton and Christopher Jacobs, Eds.) and Computer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization (JoãoManuel R.S. Tavares, Ed.). The conference has become a major international meeting on computational biomechanics, imaging andvisualization. In this edition, the main program includes 212 presentations. In addition, sixteen renowned researchers will give plenary keynotes, addressing current challenges in computational biomechanics and biomedical imaging. In Lisbon, for the first time, a session dedicated to award the winner of the Best Paper in CMBBE Journal will take place. We believe that CMBBE2018 will have a strong impact on the development of computational biomechanics and biomedical imaging and visualization, identifying emerging areas of research and promoting the collaboration and networking between participants. This impact is evidenced through the well-known research groups, commercial companies and scientific organizations, who continue to support and sponsor the CMBBE meeting series. In fact, the conference is enriched with five workshops on specific scientific topics and commercial software.info:eu-repo/semantics/draf

A semi‐active human digital twin model for detecting severity of carotid stenoses from head vibration—A coupled computational mechanics and computer vision method

In this work we propose a methodology to detect the severity of carotid stenosis from a video of a human face with the help of a coupled blood flow and head vibration model. This semi‐active digital twin model is an attempt to link non‐invasive video of a patient face to the percentage of carotid occlusion. The pulsatile nature of blood flow through the carotid arteries induces a subtle head vibration. This vibration is a potential indicator of carotid stenosis severity and it is exploited in the present study. A head vibration model has been proposed in the present work that is linked to the forces generated by blood flow with or without occlusion. The model is used to generate a large number of virtual head vibration data for different degrees of occlusion. In order to determine the in vivo head vibration, a computer vision algorithm is adopted to use human face videos. The in vivo vibrations are compared against the virtual vibration data generated from the coupled computational blood flow/vibration model. A comparison of the in vivo vibration is made against the virtual data to find the best fit between in vivo and virtual data. The preliminary results on healthy subjects and a patient clearly indicate that the model is accurate and it possesses the potential for detecting approximate severity of carotid artery stenoses

A Systematic Review on Cardiovascular Stent and Stenting Failure: Coherent Taxonomy, Performance Measures, Motivations, Open Challenges and Recommendations

Cardiovascular stenting is a mature topic but it is still being developed in the research community because of its importance. To provide worthy information about cardiovascular stenting environments and to give support to the researchers, attention must be given to understand the obtainable choices and gaps in this research field. This work aims to examine and examine the literature of each work related to the placement of cardiovascular stents, the failure of the stents and the models of stent designs to provide a good understanding through the investigation of articles published in various contextual aspects, such as motivations, open-challenges and recommendations to improve the field of stent placement. A systematic review is carried-out to map and examine the articles related to cardiovascular stents, the failure of the stents and the models of stent designs through a coherent-taxonomy used in three well-known scientific databases: ScienceDirect, IEEE Explore, and Web of Science. These databases involve literature that highlight arterial stenting. Based-on our inclusion and exception, a total of 90 articles composed the final set that offer various classes and sub-classes. The first class includes the development studies with (42/90) of experimental, computational and combined experimental and computational studies related to stent models performance and stent failure, the second class discussed studies that have been performed on stent design with (32/90), the third class is focused on the framework studies with (10/90), and the fourth class includes problems of stenting long-term with (6/90). The performance of stent designs, which is a research area that requires periodic controls, tools and procedures that could provide a stent design with good mechanical performance, reduce restenosis in the stent and increase fatigue resistance and durability. There have been numerous studies on stent performance that could promise good results in this field. The fields of research in stent designs vary, but all fields are fundamental equally. The expectation of this work could help to emphasize present research chances and, therefore, expand and make further research fields

Non-Newtonian coupled field analysis of blood flow in normal and stenosed carotid artery with varying haemodynamic parameters

Atherosclerosis is a chronic disease affecting millions worldwide by leading to heart attack and stroke. It usually develops in regions with disturbed flow like the carotid artery, aorta, and coronary arteries. The major cause of atherosclerosis development is the deposition of lipids under the endothelial layer of the artery leading to plaque build-up. Also, evidence that the plaque formation occurs mainly near the bifurcations or curvatures had led to the hypothesis that irregular flow conditions plays a major role in development and progression of atherosclerosis. In vivo and in vitro studies at the cellular level and macroscopic levels shows the importance of understanding the local haemodynamics in atherosclerosis prone regions. Although diagnostic techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) provides detailed anatomic information non-invasively, local haemodynamics can be studied at patient specific models using computational techniques like Computational Fluid Dynamics (CFD) and Fluid Structure Interaction (FSI). Therefore, it is very important to reconstruct anatomical models using CT or MRI images to gain accurate results in CFD or FSI analysis. The flow behaviour in large arteries is complex and it is influenced by the elasticity of the artery. Apart from this, the blood pressure changes during day to day activities. This interesting phenomenon of variation of blood pressure is studied by numerical simulation of blood flow in the normal and stenosed carotid artery. In this work, a three-dimensional (3D) Fluid Structure Interaction (FSI) study was carried out for a normal and stenosed patient specific carotid artery models. By considering physiological conditions, first the normal and then with hypertension disease, haemodynamic parameters were evaluated to better understand the genesis and progression of atherosclerotic plaques in the carotid artery bifurcation. Two-way FSI was performed by applying a fully implicit second-order backward Euler differencing scheme using commercial software ANSYS and ANSYS CFX (version 19.0). Arbitrary Lagrangian–Eulerian (ALE) formulation was employed to calculate the arterial response by using the temporal blood response. Due to arterial bifurcation, obvious velocity reduction and backflow formation were observed which decreased shear stress and made it oscillatory at the starting point of the internal carotid artery near the carotid sinus, which resulted in low shear stress. Oscillatory shear index (OSI) signifies oscillatory behaviour of artery wall shear stress. Comparison of the results of this study with those in the published literature showed that the regions with low wall shear stress and with OSI value greater than 0.3 pose potential risk to the development of plaques. It was observed that haemodynamics of the carotid artery was very much affected by the geometry and flow conditions. Furthermore, regions of relatively low wall shear stress were observed post stenosis, which is a known cause of plaque development and progression. The results were compared between Newtonian and Carreau – Yasuda blood viscosity models. Critical haemodynamic parameters such as wall shear stress (WSS) and Oscillatory Shear Index (OSI) were examined. Simulated hemodynamic parameters were able to capture the disturbed flow conditions in a normal and a stenosed carotid artery bifurcation, which play an important role in the development of local atherosclerotic plaques. Computational simulations based on diagnostic tools such as Ultrasound might help improving diagnostic and treatment management of carotid atherosclerosis

Computational fluid dynamics indicators to improve cardiovascular pathologies

In recent years, the study of computational hemodynamics within anatomically complex vascular regions has generated great interest among clinicians. The progress in computational fluid dynamics, image processing and high-performance computing haveallowed us to identify the candidate vascular regions for the appearance of cardiovascular diseases and to predict how this disease may evolve. Medicine currently uses a paradigm called diagnosis. In this thesis we attempt to introduce into medicine the predictive paradigm that has been used in engineering for many years. The objective of this thesis is therefore to develop predictive models based on diagnostic indicators for cardiovascular pathologies. We try to predict the evolution of aortic abdominal aneurysm, aortic coarctation and coronary artery disease in a personalized way for each patient. To understand how the cardiovascular pathology will evolve and when it will become a health risk, it is necessary to develop new technologies by merging medical imaging and computational science. We propose diagnostic indicators that can improve the diagnosis and predict the evolution of the disease more efficiently than the methods used until now. In particular, a new methodology for computing diagnostic indicators based on computational hemodynamics and medical imaging is proposed. We have worked with data of anonymous patients to create real predictive technology that will allow us to continue advancing in personalized medicine and generate more sustainable health systems. However, our final aim is to achieve an impact at a clinical level. Several groups have tried to create predictive models for cardiovascular pathologies, but they have not yet begun to use them in clinical practice. Our objective is to go further and obtain predictive variables to be used practically in the clinical field. It is to be hoped that in the future extremely precise databases of all of our anatomy and physiology will be available to doctors. These data can be used for predictive models to improve diagnosis or to improve therapies or personalized treatments.En els últims anys, l'estudi de l'hemodinàmica computacional en regions vasculars anatòmicament complexes ha generat un gran interès entre els clínics. El progrés obtingut en la dinàmica de fluids computacional, en el processament d'imatges i en la computació d'alt rendiment ha permès identificar regions vasculars on poden aparèixer malalties cardiovasculars, així com predir-ne l'evolució. Actualment, la medicina utilitza un paradigma anomenat diagnòstic. En aquesta tesi s'intenta introduir en la medicina el paradigma predictiu utilitzat des de fa molts anys en l'enginyeria. Per tant, aquesta tesi té com a objectiu desenvolupar models predictius basats en indicadors de diagnòstic de patologies cardiovasculars. Tractem de predir l'evolució de l'aneurisma d'aorta abdominal, la coartació aòrtica i la malaltia coronària de forma personalitzada per a cada pacient. Per entendre com la patologia cardiovascular evolucionarà i quan suposarà un risc per a la salut, cal desenvolupar noves tecnologies mitjançant la combinació de les imatges mèdiques i la ciència computacional. Proposem uns indicadors que poden millorar el diagnòstic i predir l'evolució de la malaltia de manera més eficient que els mètodes utilitzats fins ara. En particular, es proposa una nova metodologia per al càlcul dels indicadors de diagnòstic basada en l'hemodinàmica computacional i les imatges mèdiques. Hem treballat amb dades de pacients anònims per crear una tecnologia predictiva real que ens permetrà seguir avançant en la medicina personalitzada i generar sistemes de salut més sostenibles. Però el nostre objectiu final és aconseguir un impacte en l¿àmbit clínic. Diversos grups han tractat de crear models predictius per a les patologies cardiovasculars, però encara no han començat a utilitzar-les en la pràctica clínica. El nostre objectiu és anar més enllà i obtenir variables predictives que es puguin utilitzar de forma pràctica en el camp clínic. Es pot preveure que en el futur tots els metges disposaran de bases de dades molt precises de tota la nostra anatomia i fisiologia. Aquestes dades es poden utilitzar en els models predictius per millorar el diagnòstic o per millorar teràpies o tractaments personalitzats.Postprint (published version