Evaluation and verification of patient-specific modelling of type B aortic dissection

Armour, Chlöe Harriet; Guo, Baolei; Saitta, Simone; Pirola, Selene; Liu, Yifan; Dong, Zhihui; Xu, Xiao Yun

doi:10.1016/j.compbiomed.2021.105053

Cited by 28 publications

(18 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A key limitation of this study is that no patient-specific flow data was available, thus for the inlet and outlet boundary conditions data from the literature was utilised. Armour et al (2020a) showed that TAWSS magnitudes are highly impacted Frontiers in Bioengineering and Biotechnology frontiersin.org when non-patient-specific stroke volumes are used. While it appears that the generic inlet boundary condition did not significantly impact thrombus results in this case, likely due to the fact that there was very little flow in the thoracic FL where the thrombus formed, and therefore any error in TAWSS values would be insignificant, this may not hold in all cases.…”

Section: Discussionmentioning

confidence: 99%

Shear-driven modelling of thrombus formation in type B aortic dissection

Jafarinia

Armour

Gibbs

et al. 2022

Front. Bioeng. Biotechnol.

Self Cite

View full text Add to dashboard Cite

Background: Type B aortic dissection (TBAD) is a dangerous pathological condition with a high mortality rate. TBAD is initiated by an intimal tear that allows blood to flow between the aortic wall layers, causing them to separate. As a result, alongside the original aorta (true lumen), a false lumen (FL) develops. TBAD compromises the whole cardiovascular system, in the worst case resulting in complete aortic rupture. Clinical studies have shown that dilation and rupture of the FL are related to the failure of the FL to thrombose. Complete FL thrombosis has been found to improve the clinical outcomes of patients with chronic TBAD and is the desired outcome of any treatment. Partial FL thrombosis has been associated with late dissection-related deaths and the requirement for re-intervention, thus the level of FL thrombosis is dominant in classifying the risk of TBAD patients. Therefore, it is important to investigate and understand under which conditions complete thrombosis of the FL occurs.Method: Local FL hemodynamics play an essential role in thrombus formation and growth. In this study, we developed a simplified phenomenological model to predict FL thrombosis in TBAD under physiological flow conditions. Based on an existing shear-driven thrombosis model, a comprehensive model reduction study was performed to improve computational efficiency. The reduced model has been implemented in Ansys CFX and applied to a TBAD case following thoracic endovascular aortic repair (TEVAR) to test the model. Predicted thrombus formation based on post-TEVAR geometry at 1-month was compared to actual thrombus formation observed on a 3-year follow-up CT scan.Results: The predicted FL status is in excellent agreement with the 3-year follow-up scan, both in terms of thrombus location and total volume, thus validating the new model. The computational cost of the new model is significantly lower than the previous thrombus model, with an approximate 65% reduction in computational time. Such improvement means the new model is a significant step towards clinical applicability.Conclusion: The thrombosis model developed in this study is accurate and efficient at predicting FL thrombosis based on patient-specific data, and may assist clinicians in choosing individualized treatments in the future.

show abstract

Section: Discussionmentioning

confidence: 99%

Shear-driven modelling of thrombus formation in type B aortic dissection

Jafarinia

Armour

Gibbs

et al. 2022

Front. Bioeng. Biotechnol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…The plunging thoracic aorta is a piece of the aorta arranged in the chest. The dropping thorax aorta is a section of the aorta that starts at the left 50 percent of the fourth ventricle's lower line and ends at the T12 [2,22]. It begins at the left ventricle's top line.…”

Section: Discussionmentioning

confidence: 99%

A Spectrum of Descending Thoracic Aorta Diameter Measurement on Computerized Tomography: A Report of 500 Sudanese Patients

Elnour¹,

Elzaki²

2022

PJMHS

View full text Add to dashboard Cite

Background: The clinical show of illnesses including the thoracic aorta goes from countless patients who have no symptoms, having a medically imperceptible thoracic part of the Arora to victims with side effects of extreme ribcage torment because of intense aortic analysis. Objective: A retrospective study was conducted in computed tomography CT departments of three hospitals to quantify the average thoracic aorta width in the population of Sudan to compare it with international measurements. Methodology: The data collected from 500 randomly selected non-pathological patients were analyzed by the SPSS program and presented in tables and figures. Results: Results revealed that the diameter of the aorta is affected by the body length, age of the patient, and weight, except the gender which is a non-significant factor. Also, the typical size of the plunging part of the Aorta was 12.17±1.78 cm, the proximal diameter of the aorta was 2.51±0.56 cm, the focus width was 2.08±0.41 cm, and the distal breadth was 2.11±0.45 cm. The width of the aorta is very susceptible to size as well as out of the individual. Furthermore, an unusually large distinction (P=0.001) was seen between age and distant breadth of the aorta, although a small distinction (P=0.018) was obtained between the patient's level and terminal breadth of the aortic arch. Conclusion: It is reasoned that the figured tomography is assuming an extraordinary part in the estimation of the ordinary width of slipping of the thoracic aorta by giving a subtle depiction of sliding thoracic aorta breadth in a gathering of the solid Sudanese populace. Keywords: Thor Aorta, Computed tomography, Statistical analysis, Sudan

show abstract

“…However, among the major challenges of patient-specific computational modeling is obtaining the patient-specific input data, which directly influence result accuracy, but often are not available (Morris et al, 2016;Gray and Pathmanathan, 2018;Madhavan and Kemmerling, 2018;He et al, 2022). In the absence of patient-specific measurements, the state of the art of boundary condition estimation for CFD analysis is using data from healthy subjects reported in the literature (Lantz et al, 1981;Taylor et al, 1998;Olufsen et al, 2000) and often integrated into lumped parameter Windkessel models (Armour et al, 2022). The Windkessel model (Westerhof et al, 2009) uses electrical analogues to describe a hydraulic system, where pressure (P) and flow (Q) are analogous to voltage and current respectively (Garber et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Non-invasive estimation of the parameters of a three-element windkessel model of aortic arch arteries in patients undergoing thoracic endovascular aortic repair

Tricarico

Berceli²,

Tran‐Son‐Tay³

et al. 2023

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Background: Image-based computational hemodynamic modeling and simulations are important for personalized diagnosis and treatment of cardiovascular diseases. However, the required patient-specific boundary conditions are often not available and need to be estimated.Methods: We propose a pipeline for estimating the parameters of the popular three-element Windkessel (WK3) models (a proximal resistor in series with a parallel combination of a distal resistor and a capacitor) of the aortic arch arteries in patients receiving thoracic endovascular aortic repair of aneurysms. Pre-operative and post-operative 1-week duplex ultrasound scans were performed to obtain blood flow rates, and intra-operative pressure measurements were also performed invasively using a pressure transducer pre- and post-stent graft deployment in arch arteries. The patient-specific WK3 model parameters were derived from the flow rate and pressure waveforms using an optimization algorithm reducing the error between simulated and measured pressure data. The resistors were normalized by total resistance, and the capacitor was normalized by total resistance and heart rate. The normalized WK3 parameters can be combined with readily available vessel diameter, brachial blood pressure, and heart rate data to estimate WK3 parameters of other patients non-invasively.Results: Ten patients were studied. The medians (interquartile range) of the normalized proximal resistor, distal resistor, and capacitor parameters are 0.10 (0.07–0.15), 0.90 (0.84–0.93), and 0.46 (0.33–0.58), respectively, for common carotid artery; 0.03 (0.02–0.04), 0.97 (0.96–0.98), and 1.91 (1.63–2.26) for subclavian artery; 0.18 (0.08–0.41), 0.82 (0.59–0.92), and 0.47 (0.32–0.85) for vertebral artery. The estimated pressure showed fairly high tolerance to patient-specific inlet flow rate waveforms using the WK3 parameters estimated from the medians of the normalized parameters.Conclusion: When patient-specific outflow boundary conditions are not available, our proposed pipeline can be used to estimate the WK3 parameters of arch arteries.

show abstract

Evaluation and verification of patient-specific modelling of type B aortic dissection

Cited by 28 publications

References 54 publications

Shear-driven modelling of thrombus formation in type B aortic dissection

Shear-driven modelling of thrombus formation in type B aortic dissection

A Spectrum of Descending Thoracic Aorta Diameter Measurement on Computerized Tomography: A Report of 500 Sudanese Patients

Non-invasive estimation of the parameters of a three-element windkessel model of aortic arch arteries in patients undergoing thoracic endovascular aortic repair

Contact Info

Product

Resources

About