Computational Fluid Dynamic Technique for Assessment of How Changing Character of Blood Flow and Different Value of Hct Influence Blood Hemodynamic in Dissected Aorta

Polańczyk, Andrzej; Piechota-Polańczyk, Aleksandra; Huk, Ihor; Neumayer, Christoph; Balcer, Julia; Strzelecki, Michał

doi:10.3390/diagnostics11101866

Cited by 19 publications

(12 citation statements)

References 39 publications

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“…With the development of technique in medical diagnosis, we can add some novel variable, such as the change in blood hemodynamics which can be detected in CTA using the technique of computational fluid dynamic technique, in our model to identify patients with MPS in the future. 28 , 29 This study additionally established a nomogram for bedside application, which has implications for the education of the patient’s family and for clinical practices. As the nomogram can be readily understood, patients with acute aortic syndromes and their relatives can obtain reliable information without needing to depend on their physician’s descriptions of the prognosis of this acutely devastating condition, thereby helping them to realize the severity of the disease quickly and participate effectively in shared decision making.…”

Section: Discussionmentioning

confidence: 99%

Early Prediction Model of Acute Aortic Syndrome Mortality in Emergency Departments

Wang¹,

Zhang²,

Du³

et al. 2022

IJGM

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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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Section: Discussionmentioning

confidence: 99%

Early Prediction Model of Acute Aortic Syndrome Mortality in Emergency Departments

Wang¹,

Zhang²,

Du³

et al. 2022

IJGM

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“…Furthermore, Polanczyk et al have proposed a CFD approach to simulate the wall shear stress on the aortic wall. The results reveal that the higher blood velocity depicts the lower blood velocity and shear rate whereas the higher wall shear stress occurs owing to the velocity gradient near the wall surface 30 …”

Section: Introductionmentioning

confidence: 95%

“…The results reveal that the higher blood velocity depicts the lower blood velocity and shear rate whereas the higher wall shear stress occurs owing to the velocity gradient near the wall surface. 30 The fluid shear stress owing to the normal and altered blood flow patterns affects the cerebrovascular blood vessels. This has initiated extensive research on the microfluidic cerebrovascular channels to enumerate the capillary interface of the brain for mimicking the in-vivo level shear stress.…”

Section: Introductionmentioning

confidence: 99%

Computational fluid dynamics based Taguchi analysis on shear stress in microfluidic cerebrovascular channels

Garud

Jeong

Lee

2023

Numer Methods Biomed Eng

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The cerebrovascular blood vessels feed necessary agents such as oxygen, glucose, and so forth. to the brain which maintains the smooth functioning of the human body. However, the blood-brain barrier as a vascular border restricts the entry of drugs that can be necessary for the treatment of neurological disorders. The fluid shear stress in the cerebrovascular blood vessels may regulate the drug delivery in the interface between the cerebrovascular blood vessels and the brain. The intensity of influence by various factors that affects the shear stress in the cerebrovascular blood vessels is scarcely addressed in the present study. A hybrid approach of computational fluid dynamics and Taguchi analysis is proposed to evaluate the influence of various geometrical and operating factors on the shear stress in the microfluidic cerebrovascular channel. Furthermore, the non-Newtonian behavior of blood flow is considered to evaluate the shear stress in the microfluidic cerebrovascular channel. The Newtonian and six non-Newtonian fluids models of Carreau, Carreau-Yasuda, Casson, Cross, Ostwald-de Waele, and Herschel-Bulkley are numerically tested under various conditions of the flow rate, width, and height of the channel to find the viscosity influence on the shear stress. The Taguchi analysis consisting of range and variance analyses is applied to the L 16 orthogonal array to evaluate the effect of various factors on shear stress in terms of influence order, range, F value, and percentage contribution. The parameters for the considered six non-Newtonian fluid models are proposed to accurately map the viscosity behavior with shear strain compared to the actual blood flow behavior. The Newtonian, Carreau, and Carreau-Yasuda non-Newtonian fluid models are found accurately with maximum errors between the experimental and numerical shear stress results as 2.17%, 1.30%, and 1.48%, respectively. The shear stress decreases with an increase in the width and height of the channel and a decrease in the viscosity for all flow rates. The porosity is evaluated as a highly influential factor followed by the flow rate, width, and height of the channel in decreasing order based on their effects on the shear stress. The modified shear stress equation is proposed with an accuracy of 0.96 by integrating the effect of porosity in addition to width, height, flow rate, and viscosity. The in-vitro microfluidic cerebrovascular model could be designed and manufactured based on the proposed results on influence order, F value, and

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“…With the rapid development of computational uid dynamics (CFD), the parameters of intra-arterial hemodynamics can be quickly evaluated. These parameters become a reliable tool to understand hemodynamics, pathological vascular disease progress, and to predict the performance of medical equipment [21][22]. Moreover, they can avoid the drawbacks of limited prospective research in clinical trials, time-consuming procedures, high costs, and ethical problems [23].…”

Section: Introductionmentioning

confidence: 99%

Effects of two different surgical methods for endovascular repair of the thoracic aorta on the hemodynamics of the left subclavian artery

Li,

Yuan,

Wen

et al. 2023

Preprint

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Background: Some clinicians use endograft to partially cover the left subclavian artery (LSA) ostium or multilayer flow modulator (MFM) to mitigate cases with an insufficient landing area in thoracic endovascular aortic repair(TEVAR) treatment. So we used computational fluid dynamics (CFD) to study the effects of two surgical methods on the hemodynamics of the LSA, due to they may affect the long-term patency rate of the LSA. Methods: The digital model of the aortic arch was established and named model A, which only included supraarch branch the LSA. The simulated digital model of the MFM was implanted into model A, named as model B. By directly covering one half of the LSA ostium, which was named as model C. All established models were imported into the Gambit grid division software for grid division and were subsequently imported into the Fluent software for hemodynamic numerical simulation and calculation. The changes in the related hemodynamic parameters of the LSA after implantation of the two stents were analyzed and compared. Results: Under the same aortic inlet flow, in model C, the lumen flow of the LSA was obviously reduced and the distal descending aorta flow was increased, the local blood flow velocity of LSA ostium increased and whole blood flow velocity at the distal end decreased. The average wall shear stress(WSS) of the LSA was significantly decreased. Meanwhile there was an obvious turbulent flow in the LSA lumen, and the related blood flow state was disordered. However, all changes in model B was occured, they changed slightly compared with model A. Conclusion: CFD research confirmed that the implantation of an MFM had little influence on the hemodynamics of the LSA. In contrast, the implantation of an endograft partially covering the LSA ostium increased the local ostium velocity. But it reduced the global flow rate, velocity, and average wall shear stress at the distal end. This change is likely to cause a long-term hardening and an acute thrombosis of the LSA artery. Nevertheless, this operation can also be used in specific clinical cases.

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Computational Fluid Dynamic Technique for Assessment of How Changing Character of Blood Flow and Different Value of Hct Influence Blood Hemodynamic in Dissected Aorta

Cited by 19 publications

References 39 publications

Early Prediction Model of Acute Aortic Syndrome Mortality in Emergency Departments

Early Prediction Model of Acute Aortic Syndrome Mortality in Emergency Departments

Computational fluid dynamics based Taguchi analysis on shear stress in microfluidic cerebrovascular channels

Effects of two different surgical methods for endovascular repair of the thoracic aorta on the hemodynamics of the left subclavian artery

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