Experimentelle Untersuchung der radialen Verformbarkeit von Stents

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.Infolge der mechanischen Unterstützung der Gefäßwand nach Stentimplantation kann eine akute Durchmesservergrößerung gegenüber konventioneller Ballonangioplastie (PTCA) erreicht und die Restenoserate gesenkt werden. Eine ausreichende Widerstandsfähigkeit gegenüber äußeren Kräften ist eine Grundvoraussetzung für optimale Ergebnisse in der Stentapplikation. Aufgrund der Vielzahl der verwendeten Materialien und Gestaltungsprinzipien bestehen große Unterschiede in dem mechanischen Verhalten der kommerziell verfügbaren Stents. Die Kenntnis dieser Verhaltensweisen stellt eine essentielle Grundlage einer an die Läsion angepaßten Stentauswahl dar. Obwohl bisher verschiedene Studien das Stentverhalten analysierten, fehlt es aufgrund unterschiedlicher Prüfverfahren an einer Vergleichbarkeit der Ergebnisse. Ziel dieses Beitrages ist die parallele Untersuchung von acht aktuellen Stenttypen. Zu diesem Zweck wurde eine Ultraschall-Meßvorrichtung zur standardisierten, quantitativen Evaluation der kompressiv-mechanischen Eigenschaften von Koronarstents entwickelt. Mit Hilfe dieser Vorrichtung konnte darüberhinaus der Einfluß der Stentimplantation auf das radiale Dehnungsverhalten der Arterienwand untersucht werden

Turbine Powered Simulator Calibration and Testing for Hybrid Wing Body Powered Airframe Integration

Propulsion airframe integration testing on a 5.75% scale hybrid wing body model us- ing turbine powered simulators was completed at the National Full-Scale Aerodynamics Complex 40- by 80-foot test section. Four rear control surface con gurations including a no control surface de ection con guration were tested with the turbine powered simulator units to investigate how the jet exhaust in uenced the control surface performance as re- lated to the resultant forces and moments on the model. Compared to ow-through nacelle testing on the same hybrid wing body model, the control surface e ectiveness was found to increase with the turbine powered simulator units operating. This was true for pitching moment, lift, and drag although pitching moment was the parameter of greatest interest for this project. With the turbine powered simulator units operating, the model pitching moment was seen to increase when compared to the ow-through nacelle con guration indicating that the center elevon and vertical tail control authority increased with the jet exhaust from the turbine powered simulator units

Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

BACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the relative merits of either technique in treatment of unstable angina. Methods and Results- Seven hundred fifty-five patients with stable angina were randomly assigned to coronary stenting (374) or bypass surgery (381), and 450 patients with unstable angina were randomly assigned to coronary stenting (226) or bypass surgery (224). All patients had multivessel disease considered to be equally treatable by either technique. Freedom from major adverse events, including death, myocardial infarction, and cerebrovascular events, at 1 year was not different in unstable patients (91.2% versus 88.9%) and stable patients (90.4% versus 92.6%) treated, respectively, with coronary stenting or bypass surgery. Freedom from repeat revascularization at 1 year was similar in unstable and stable angina treated with stenting (79.2% versus 78.9%) or bypass surgery (96.3% versus 96%) but was significantly higher in both unstable and stable patients treated with stenting (16.8% versus 16.9%) compared with bypass surgery (3.6% versus 3.5%). Neither the difference in costs between stented or bypassed stable or unstable angina ($2594 versus$3627) nor the cost-effectiveness was significantly different at 1 year. CONCLUSIONS: There was no difference in rates of death, myocardial infarction, and cerebrovascular event at 1 year in patients with unstable angina and multivessel disease treated with either stented angioplasty or bypass surgery compared with patients with stable angina. The rate of repeat revascularization of both unstable and stable angina was significantly higher in patients with stents

Experimental Evaluation of Inlet Distortion on an Ejector Powered Hybrid Wing Body at Take-off and Landing Conditions

As part of the NASA Environmentally Responsible Aircraft project, an ultra high bypass ratio engine integration on a hybrid wing body demonstration was planned. The goal was to include engine and airframe integration concepts that reduced fuel consumption by at least 50% while still reducing noise 42 db cumulative on the ground. Since the engines would be mounted on the upper surface of the aft body of the aircraft, the inlets may be susceptible to vortex ingestion from the wing leading edge at high angles of attack and sideslip, and separated wing/body flow. Consequently, experimental and computational studies were conducted to collect flow surveys useful for characterizing engine operability. The wind tunnel tests were conducted at two NASA facilities, the 14- by 22-foot at NASA Langley and the 40- by 80-foot at NASA Ames Research Center. The test results included in this paper show that the distortion and pressure recovery levels were acceptable for engine operability. The CFD studies conducted to compare to experimental data showed excellent agreement for the angle of attacks examined, although failed to match the low speed experimental data at high sideslip angles

Computational Evaluation of Inlet Distortion on an Ejector Powered Hybrid Wing Body at Takeoff and Landing Conditions

Due to the aft, upper surface engine location on the Hybrid Wing Body (HWB) planform, there is potential to shed vorticity and separated wakes into the engine when the vehicle is operated at off-design conditions and corners of the envelope required for engine and airplane certification. CFD simulations were performed of the full-scale reference propulsion system, operating at a range of inlet flow rates, flight speeds, altitudes, angles of attack, and angles of sideslip to identify the conditions which produce the largest distortion and lowest pressure recovery. Pretest CFD was performed by NASA and Boeing, using multiple CFD codes, with various turbulence models. These data were used to make decisions regarding model integration, characterize inlet flow distortion patterns, and help define the wind tunnel test matrix. CFD was also performed post-test; when compared with test data, it was possible to make comparisons between measured model-scale and predicted full-scale distortion levels. This paper summarizes these CFD analyses

Dependence of Intramyocardial Pressure and Coronary Flow on Ventricular Loading and Contractility: A Model Study

The phasic coronary arterial inflow during the normal cardiac cycle has been explained with simple (waterfall, intramyocardial pump) models, emphasizing the role of ventricular pressure. To explain changes in isovolumic and low afterload beats, these models were extended with the effect of three-dimensional wall stress, nonlinear characteristics of the coronary bed, and extravascular fluid exchange. With the associated increase in the number of model parameters, a detailed parameter sensitivity analysis has become difficult. Therefore we investigated the primary relations between ventricular pressure and volume, wall stress, intramyocardial pressure and coronary blood flow, with a mathematical model with a limited number of parameters. The model replicates several experimental observations: the phasic character of coronary inflow is virtually independent of maximum ventricular pressure, the amplitude of the coronary flow signal varies about proportionally with cardiac contractility, and intramyocardial pressure in the ventricular wall may exceed ventricular pressure. A parameter sensitivity analysis shows that the normalized amplitude of coronary inflow is mainly determined by contractility, reflected in ventricular pressure and, at low ventricular volumes, radial wall stress. Normalized flow amplitude is less sensitive to myocardial coronary compliance and resistance, and to the relation between active fiber stress, time, and sarcomere shortening velocity

Mechanical effects of left ventricular midwall fibrosis in non-ischemic cardiomyopathy

Background: Left ventricular (LV) mid-wall fibrosis (MWF), which occurs in about a quarter of patients with non-ischemic cardiomyopathy (NICM), is associated with high risk of pump failure. The mid LV wall is the site of circumferential myocardial fibers. We sought to determine the effect of MWF on LV myocardial mechanics. Methods: Patients with NICM (n = 116; age: 62.8 ± 13.2 years; 67 % male) underwent late gadolinium enhancement cardiovascular magnetic resonance (CMR) and were categorized according to the presence (+) or absence (-) of MWF. Feature tracking (FT) CMR was used to assess myocardial deformation. Results: Despite a similar LVEF (24.3 vs 27.5 %, p = 0.20), patients with MWF (32 [24 %]) had lower global circumferential strain (εcc: -6.6 % vs -9.4 %, P = 0.004), but similar longitudinal (εll: -7.6 % vs. -9.4 %, p = 0.053) and radial (εrr: 14.6 % vs. 17.8 % p = 0.18) strain. Compared with - MWF, + MWF was associated with reduced LV systolic, circumferential strain rate (-0.38 ± 0.1 vs -0.56 ± 0.3 s-1, p = 0.005) and peak LV twist (4.65 vs. 6.31°, p = 0.004), as well as rigid LV body rotation (64 % vs 28 %, P cc: 0.34 vs. 0.46 s-1; DSRll: 0.38 vs. 0.50s-1; DSRrr: -0.55 vs. -0.75 s-1; all