Evaluating the Haemodynamic Performance of Endografts for Complex Aortic Arch Repair

Sengupta, Sampad; Zhu, Yanhe; Hamady, Mohamad; Xu, Xiao Yun

doi:10.3390/bioengineering9100573

Cited by 8 publications

(7 citation statements)

References 85 publications

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“…Time-Averaged Wall Shear Stress (TAWSS) is the average WSS magnitude during one cardiac cycle [33]. It is de ined as:…”

Section: Resultsmentioning

confidence: 99%

“…• Oscillatory Shear Index (OSI) was developed to account for the wall shear stress vector's cyclic deviance from its primary axial alignment [33,36] and it is de ined as:…”

Section: Resultsmentioning

confidence: 99%

“…• The relative residence time (RRT) is a criterion for disturbance of blood low [33]. It is proportional to the magnitude of the TAWSS:…”

Section: Resultsmentioning

confidence: 99%

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A proposal of risk indicators for pathological development from hemodynamic simulation: application to aortic dissection

Wenyang¹,

Kulisa²,

Bou‐Saïd³

et al. 2023

J Cardiol Cardiovasc Med

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Cardiovascular diseases are the leading cause of mortality in the industrialized world. Among these diseases, aortic dissection affects the aorta wall and is a surgical emergency with a low survival rate. This pathology occurs when an injury leads to a localized tear of the innermost layer of the aorta. It allows blood to flow between the layers of the aortic wall, forcing the layers apart and creating a false lumen. Endovascular treatment seeks to obliterate the entrances to the false lumen with a covered stent. There are very few studies on the postoperative demonstration of blood flow phenomena in the aortic dissection endovascular treatment. It is crucial to study the hemodynamics of blood in the aorta after an intervention because the new geometrical configuration of the aorta with a stent leads to modifications in blood flow. For the surgeons, the procedure can only be performed empirically, using MRI-4D images to view the postoperative flow of the patient’s blood in the aorta with the stent. This paper aims to present a numerical tool developed from the open-source software FOAM- Extend®, allowing for multiphysics numerical simulations. Using MRI data, a bio-faithful model of the patient-specific case was built. Numerical simulations were performed to predict preoperative and postoperative (endovascular treatment) hemodynamics. The modifications of the flow in the aorta were analyzed focusing on the postoperative perfusions. The results were compared with the corresponding MRI data and have a good qualitative agreement. Biomarkers are calculated to localize possible zones of post-operative pathological developments and recommendations may be suggested to the surgeons.

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“…Time-Averaged Wall Shear Stress (TAWSS) is the average WSS magnitude during one cardiac cycle [33]. It is de ined as:…”

Section: Resultsmentioning

confidence: 99%

“…• Oscillatory Shear Index (OSI) was developed to account for the wall shear stress vector's cyclic deviance from its primary axial alignment [33,36] and it is de ined as:…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A proposal of risk indicators for pathological development from hemodynamic simulation: application to aortic dissection

Wenyang¹,

Kulisa²,

Bou‐Saïd³

et al. 2023

J Cardiol Cardiovasc Med

View full text Add to dashboard Cite

show abstract

“…These findings have not been presented in prior literature. Sengupta et al 29 undertook CFD analysis in a rigid geometry similar to configuration C, but without the BC bypass. These important distinctions in geometry, FSI, and their incomplete model parameter definition makes comparison across papers difficult.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Flow Through Extra-Anatomic Bypasses Between Supra-Aortic Branches Using Particle Image Velocimetry (PIV)

Williamson,

Docherty,

Khanafer

et al. 2024

Clin Med Insights Cardiol

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Supra-aortic extra-anatomic debranch (SAD) are prosthetic surgical grafts used to revascularize head and neck arteries that would be blocked during a surgical or hybrid procedure used in treating ascending and arch of the aorta pathologies. However, bypassing the supra-aortic arteries but not occluding their orifice might introduce potential for competitive flow that reduces bypass patency. Competitive flow within the bypasses across the supra-aortic arteries has not previously been identified. This research identified haemodynamics due to prophylactic inclusion of bypasses from the brachiocephalic artery (BCA) to the left common carotid artery (LCCA), and from the LCCA to left subclavian artery (LSA). Four model configurations investigated the risk of competitive flow and the necessity of intentionally blocking the proximal LSA and/or LCCA. Particle image velocimetry (PIV) was used to assess haemodynamics in each model configuration. We found potential for competitive flow in the BCA-LCCA bypass when the LSA was blocked, in the LSA-LCCA bypass, when the LCCA alone or LCCA and LSA were blocked. Flow stagnated at the start of systole within the RCCA-LCCA bypass, along with notable recirculation zones and reciprocating flow occurring throughout systolic flow. Flow also stagnated in the LCCA-LSA bypass when the LCCA was blocked. There was a large recirculation in the LCCA-LSA bypass when both the LCCA and LSA were blocked. The presence of competitive flow in all other configurations indicated that it is necessary to block or ligate the native LCCA and LSA once the debranch is made and the thoracic endovascular aortic repair (TEVAR) completed.

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“…From the clinical point of view, crucial for the successful treatment of thoracic aortic diseases is a deep knowledge of the whole anatomy of the aortic arch in relation to the origins of the supra-aortic arteries. This area is affected by several pathologies, such as aneurysms and dissections, which can currently be treated with open surgery, endovascular or hybrid procedures ( Pérez et al, 2017 ; Sengupta et al, 2022 ). In all cases, the fundamental aspect is to ensure the vascularization of the supra-aortic vessels in order to avoid adverse events such as ischemic strokes, which lead to brain cell damage or death.…”

Section: Discussionmentioning

confidence: 99%

Enabling supra-aortic vessels inclusion in statistical shape models of the aorta: a novel non-rigid registration method

Scarpolini¹,

Mazzoli²,

Celi³

2023

Front. Physiol.

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Statistical Shape Models (SSMs) are well-established tools for assessing the variability of 3D geometry and for broadening a limited set of shapes. They are widely used in medical imaging due to their ability to model complex geometries and their high efficiency as generative models. The principal step behind these techniques is a registration phase, which, in the case of complex geometries, can be a critical issue due to the correspondence problem, as it necessitates the development of correspondence mapping between shapes. The thoracic aorta, with its high level of morphological complexity, poses a multi-scale deformation problem due to the presence of several branch vessels with varying diameters. Moreover, branch vessels exhibit significant variability in shape, making the correspondence optimization even more challenging. Consequently, existing studies have focused on developing SSMs based only on the main body of the aorta, excluding the supra-aortic vessels from the analysis. In this work, we present a novel non-rigid registration algorithm based on optimizing a differentiable distance function through a modified gradient descent approach. This strategy enables the inclusion of custom, domain-specific constraints in the objective function, which act as landmarks during the registration phase. The algorithm’s registration performance was tested and compared to an alternative Statistical Shape modeling framework, and subsequently used for the development of a comprehensive SSM of the thoracic aorta, including the supra-aortic vessels. The developed SSM was further evaluated against the alternative framework in terms of generalisation, specificity, and compactness to assess its effectiveness.

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Evaluating the Haemodynamic Performance of Endografts for Complex Aortic Arch Repair

Cited by 8 publications

References 85 publications

A proposal of risk indicators for pathological development from hemodynamic simulation: application to aortic dissection

A proposal of risk indicators for pathological development from hemodynamic simulation: application to aortic dissection

Analysis of Flow Through Extra-Anatomic Bypasses Between Supra-Aortic Branches Using Particle Image Velocimetry (PIV)

Enabling supra-aortic vessels inclusion in statistical shape models of the aorta: a novel non-rigid registration method

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