Computing patient-specific hemodynamics in stented femoral artery models obtained from computed tomography using a validated 3D reconstruction method

Colombo, Monika; Bologna, Marco; Garbey, Marc; Berceli, Scott A.; He, Yong; Matas, José Félix Rodríguez; Migliavacca, Francesco; Chiastra, Claudio

doi:10.1016/j.medengphy.2019.10.005

Cited by 43 publications

(46 citation statements)

References 51 publications

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“…Helical blood flow structures developing into the endoprostheses are represented in Fig. 7 using iso-surfaces of LNH at the systolic peak with a threshold of ± 0.25, according to Colombo et al [8], for both the patients in straight-leg configuration, relating to the scenario A1. The results show Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In particular, the flow extensions that we used in the simulations have been chosen in order to reduce the effect of the arbitrary choice of the velocity profile. They were modeled using VMTK, with a length corresponding to 3.5 times the dimension of the inlet diameter, according to Colombo et al [8]. The following inlet boundary conditions were tested:…”

Section: Methodsmentioning

confidence: 99%

“…However, the proposed work was based on vessel geometries reconstructed from 2D angiographic images thus idealizing the lumen cross-sections. This limitation was overcome by Colombo et al [8], who presented a fully patient-specific computational framework based on geometric reconstructions from Computed Tomography (CT) images and boundary conditions taken from Doppler ultrasound images. However, despite the proposed innovations, only the straight-leg configuration has been studied, thus neglecting the analysis of the effects of leg bending on the geometry and hemodynamics of the stented area.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, while some studies highlighted the importance of the non-Newtonian rheology [13], others found that the use of a Newtonian blood model represents a good approximation [14,15]. In particular, focusing on modeling of the FPA, most of the studies [3,6,16] assumed a constant viscosity, even if Colombo et al [8] adopted the Carreau model to describe the non-Newtonian viscosity of blood.…”

Section: Introductionmentioning

confidence: 99%

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Impact of leg bending in the patient-specific computational fluid dynamics of popliteal stenting

et al. 2021

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Endovascular treatment of the femoro-popliteal artery has recently become a valuable therapeutic option for popliteal arterial aneurysms. However, its efficacy remains controversial due to the relatively high rate of complications, such as stent occlusion as result of intra-stent thrombosis. The elucidation of the interplay among vessel geometrical features, local hemodynamics, and leg bending seems crucial to understand onset and progression of popliteal intra-stent thrombosis. To this aim, patient-specific computational fluid dynamic simulations were performed in order to assess the intra-stent hemodynamics of two patients endovascularly treated for popliteal arterial aneurysm by stent-grafts and experiencing intra-stent thrombosis. Both Newtonian and non-Newtonian blood rheological models were considered. Results were presented in terms of tortuosity, luminal area exposed to low (< 0.4 Pa) and high (> 1.5 Pa) time-averaged wall shear stress (TAWSS), area exposed to high (> 0.3) oscillatory shear index (OSI), and flow helicity. Study outcomes demonstrated that leg bending induced significant hemodynamic differences (> 50% increase) in both patients for all the considered variables, except for OSI in one of the two considered patients. In both leg configurations, stent-graft overlapping induced a severe discontinuity of the lumen diameter where the proximal stented zone is characterized by low tortuosity, low velocity, low helicity, low TAWSS, and high OSI; while the distal part has higher tortuosity, velocity, helicity, TAWSS, and lower OSI. Sensitivity study on applied boundary conditions showed that the different inlet velocity profiles for a given inlet waveform affect slightly the numerical solution; conversely, the shape and magnitude of the prescribed inlet waveform is determinant. Focusing on the comparison between the Newtonian and non-Newtonian blood models, the area with low TAWSS is greater in the Newtonian model for both patients, while no significant difference occurs between the surfaces with high TAWSS. GraphicAbstract Patient-specific computational fluid dynamic simulations were performed in order to assess the intra-stent hemodynamics of two patients endovascularly treated for popliteal arterial aneurysm and experiencing intra-stent thrombosis. Both Newtonian and non-Newtonian blood rheological models were considered. In both straight and bent leg configurations, stent-graft overlapping induced a severe discontinuity of the lumen diameter where the proximal stented zone is characterized by low tortuosity, low velocity, low helicity, low time-averaged wall shear stress (TAWSS), and high oscillatory index (OSI); while the distal part has higher tortuosity, velocity, helicity, TAWSS, and lower OSI.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of leg bending in the patient-specific computational fluid dynamics of popliteal stenting

et al. 2021

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“…A better understanding of the disease burden can result in better procedural planning and outcomes. Moreover, the 3D reconstructed bifurcation lumen itself can be used for computational and experimental (bench) fluid dynamics studies to explore the role of flow in native coronary artery disease development and progression, as well as in stent restenosis and thrombosis 19,24,26,27 . Our methodology provides the accurate geometrical input needed for realistic computational fluid dynamics studies.…”

Section: Oct Segmentation 45 ± 15mentioning

confidence: 99%

3D reconstruction of coronary artery bifurcations from coronary angiography and optical coherence tomography: feasibility, validation, and reproducibility

Samant

Zwart

et al. 2020

Sci Rep

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The three-dimensional (3D) representation of the bifurcation anatomy and disease burden is essential for better understanding of the anatomical complexity of bifurcation disease and planning of stenting strategies. We propose a novel methodology for 3D reconstruction of coronary artery bifurcations based on the integration of angiography, which provides the backbone of the bifurcation, with optical coherence tomography (OCT), which provides the vessel shape. Our methodology introduces several technical novelties to tackle the OCT frame misalignment, correct positioning of the OCT frames at the carina, lumen surface reconstruction, and merging of bifurcation lumens. The accuracy and reproducibility of the methodology were tested in n = 5 patient-specific silicone bifurcations compared to contrast-enhanced micro-computed tomography (µCT), which was used as reference. The feasibility and time-efficiency of the method were explored in n = 7 diseased patient bifurcations of varying anatomical complexity. The OCT-based reconstructed bifurcation models were found to have remarkably high agreement compared to the µCT reference models, yielding r2 values between 0.91 and 0.98 for the normalized lumen areas, and mean differences of 0.005 for lumen shape and 0.004 degrees for bifurcation angles. Likewise, the reproducibility of our methodology was remarkably high. Our methodology successfully reconstructed all the patient bifurcations yielding favorable processing times (average lumen reconstruction time < 60 min). Overall, our method is an easily applicable, time-efficient, and user-friendly tool that allows accurate and reproducible 3D reconstruction of coronary bifurcations. Our technique can be used in the clinical setting to provide information about the bifurcation anatomy and plaque burden, thereby enabling planning, education, and decision making on bifurcation stenting.

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Improving Understanding of Cardiovascular Structures: A Workflow to Visualize Patient-Specific Simulations in Virtual Reality

Crascì,

Pajaziti,

Pasta

et al. 2024

Lecture Notes in Computer Science

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Computing patient-specific hemodynamics in stented femoral artery models obtained from computed tomography using a validated 3D reconstruction method

Cited by 43 publications

References 51 publications

Impact of leg bending in the patient-specific computational fluid dynamics of popliteal stenting

Impact of leg bending in the patient-specific computational fluid dynamics of popliteal stenting

3D reconstruction of coronary artery bifurcations from coronary angiography and optical coherence tomography: feasibility, validation, and reproducibility

Improving Understanding of Cardiovascular Structures: A Workflow to Visualize Patient-Specific Simulations in Virtual Reality

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