Applicability analysis to evaluate credibility of an in silico thrombectomy procedure

Luraghi, Giulia; Bridio, Sara; Miller, Claire; Hoekstra, Alfons G.; Matas, José Félix Rodríguez; Migliavacca, Francesco

doi:10.1016/j.jbiomech.2021.110631

Cited by 14 publications

(12 citation statements)

References 21 publications

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“…Second, these tools could be used to simulate different stent designs and test them in different scenarios that are difficult to test in vivo or with in vitro set-ups. Indeed, other studies have shown that computational tools are reliable enough to be applied as a testbed for experimental purposes [19,47]. The parametric stent design detailed in this work can be modified to test other device configurations in future studies.…”

Section: Discussionmentioning

confidence: 99%

Realistic computer modelling of stent retriever thrombectomy: a hybrid finite-element analysis-smoothed particle hydrodynamics model

Faghihi

Sommer

et al. 2021

J. R. Soc. Interface.

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Stent retriever thrombectomy is a pre-eminent treatment modality for large vessel ischaemic stroke. Simulation of thrombectomy could help understand stent and clot mechanics in failed cases and provide a digital testbed for the development of new, safer devices. Here, we present a novel, in silico thrombectomy method using a hybrid finite-element analysis (FEA) and smoothed particle hydrodynamics (SPH). Inspired by its biological structure and components, the blood clot was modelled with the hybrid FEA–SPH method. The Solitaire self-expanding stent was parametrically reconstructed from micro-CT imaging and was modelled as three-dimensional finite beam elements. Our simulation encompassed all steps of mechanical thrombectomy, including stent packaging, delivery and self-expansion into the clot, and clot extraction. To test the feasibility of our method, we simulated clot extraction in simple straight vessels. This was compared against in vitro thrombectomies using the same stent, vessel geometry, and clot size and composition. Comparisons with benchtop tests indicated that our model was able to accurately simulate clot deflection and penetration of stent wires into the clot, the relative movement of the clot and stent during extraction, and clot fragmentation/embolus formation. In this study, we demonstrated that coupling FEA and SPH techniques could realistically model stent retriever thrombectomy.

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Section: Discussionmentioning

confidence: 99%

Realistic computer modelling of stent retriever thrombectomy: a hybrid finite-element analysis-smoothed particle hydrodynamics model

Faghihi

Sommer

et al. 2021

J. R. Soc. Interface.

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“…These guidelines only refer to medical devices and pharmacokinetics, thus future efforts are needed to define suitable protocols and methods for wider biomedical applications. The criticality of computational model verification, uncertainty quantification, calibration and validation in the biomedical field is also demonstrated by recent publications (Marino et al, 2008;Luraghi et al, 2018;Nikishova et al, 2018Nikishova et al, , 2019Fleeter et al, 2020;Ye et al, 2021a;Curreli et al, 2021;Groen et al, 2021;Luraghi et al, 2021;Rapadamnaba et al, 2021).…”

Section: Challenges and Future Directions Verification Uncertainty Quantification Calibration And Validationmentioning

confidence: 96%

Multiscale Computational Modeling of Vascular Adaptation: A Systems Biology Approach Using Agent-Based Models

Corti

Colombo

Migliavacca

et al. 2021

Front. Bioeng. Biotechnol.

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The widespread incidence of cardiovascular diseases and associated mortality and morbidity, along with the advent of powerful computational resources, have fostered an extensive research in computational modeling of vascular pathophysiology field and promoted in-silico models as a support for biomedical research. Given the multiscale nature of biological systems, the integration of phenomena at different spatial and temporal scales has emerged to be essential in capturing mechanobiological mechanisms underlying vascular adaptation processes. In this regard, agent-based models have demonstrated to successfully embed the systems biology principles and capture the emergent behavior of cellular systems under different pathophysiological conditions. Furthermore, through their modular structure, agent-based models are suitable to be integrated with continuum-based models within a multiscale framework that can link the molecular pathways to the cell and tissue levels. This can allow improving existing therapies and/or developing new therapeutic strategies. The present review examines the multiscale computational frameworks of vascular adaptation with an emphasis on the integration of agent-based approaches with continuum models to describe vascular pathophysiology in a systems biology perspective. The state-of-the-art highlights the current gaps and limitations in the field, thus shedding light on new areas to be explored that may become the future research focus. The inclusion of molecular intracellular pathways (e.g., genomics or proteomics) within the multiscale agent-based modeling frameworks will certainly provide a great contribution to the promising personalized medicine. Efforts will be also needed to address the challenges encountered for the verification, uncertainty quantification, calibration and validation of these multiscale frameworks.

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“…1,10,17 Luraghi et al implemented a computational model of mechanical thrombectomy with a stent retriever. 14 Other researchers focused on the effects of aspiration thrombectomy for ischemic stroke modelling a cylindrical vessel segment. 13,20 Neidlin et al performed a numerical investigation on hemodynamics in a full CoW during distal thrombus aspiration.…”

Section: Introductionmentioning

confidence: 99%

“…implemented a computational model of mechanical thrombectomy with a stent retriever. 14 Other researchers focused on the effects of aspiration thrombectomy for ischemic stroke modelling a cylindrical vessel segment. 13 , 20 Neidlin et al .…”

Section: Introductionmentioning

confidence: 99%

Investigation of Cerebral Hemodynamics During Endovascular Aspiration: Development of an Experimental and Numerical Setup

Luisi

Amiri

Büsen

et al. 2023

Cardiovasc Eng Tech

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Purpose Acute ischemic stroke is a life-threatening emergency caused by an occlusion of a cerebral artery through a blood clot. Aspiration thrombectomy is an endovascular therapy for the removal of vessel occlusions. However, open questions regarding the hemodynamics during the intervention remain, motivating investigations of blood flow within cerebral arteries. In this study, we present a combined experimental and numerical approach to analyze hemodynamics during endovascular aspiration. Methods We have developed an in vitro setup for investigations of hemodynamic changes during endovascular aspiration within a compliant model of patient-specific cerebral arteries. Pressures, flows, and locally resolved velocities were obtained. In addition, we established a computational fluid dynamics (CFD) model and compared the simulations during physiological conditions and in two aspiration scenarios with different occlusions. Results Flow redistribution within cerebral arteries after ischemic stroke is strongly dependent on the severity of the occlusion and on the volume flow extracted by endovascular aspiration. Numerical simulations exhibit an excellent correlation of R = 0.92 for flow rates and a good correlation of R = 0.73 for pressures. Further on, the local velocity field inside the basilar artery had a good agreement between CFD model and particle image velocimetry (PIV) data. Conclusion The presented setup allows for in vitro investigations of artery occlusions and endovascular aspiration techniques on arbitrary patient-specific cerebrovascular anatomies. The in silico model provides consistent predictions of flows and pressures in several aspiration scenarios.

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Applicability analysis to evaluate credibility of an in silico thrombectomy procedure

Cited by 14 publications

References 21 publications

Realistic computer modelling of stent retriever thrombectomy: a hybrid finite-element analysis-smoothed particle hydrodynamics model

Realistic computer modelling of stent retriever thrombectomy: a hybrid finite-element analysis-smoothed particle hydrodynamics model

Multiscale Computational Modeling of Vascular Adaptation: A Systems Biology Approach Using Agent-Based Models

Investigation of Cerebral Hemodynamics During Endovascular Aspiration: Development of an Experimental and Numerical Setup

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