Hemodynamic mechanism of pulsatile tinnitus caused by venous diverticulum treated with coil embolization

Liu, Li; Mu, Zhenxia; Kang, Yizhou; Huang, Suqin; Qiu, Xiaoyu; Xue, Xiaofei; Fu, Minrui; Xue, Qingxin; Lv, Han; Gao, Bin; Shu, Li; Zhao, Peng; Ding, Heyu; Wang, Zhenchang

doi:10.1016/j.cmpb.2022.106617

Cited by 7 publications

(3 citation statements)

References 33 publications

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“…Blood flow velocity less than 5 mm/s may cause thrombosis 34 ; therefore, a velocity of <5 mm/s and a shear rate of <49/s were selected as the criteria for stagnant blood to predict the extent of simulated thrombus formation 35 . The addition of shear rate criteria was to exclude the low velocity experienced by the wall due to the no‐slip wall boundary condition.…”

Section: Resultsmentioning

confidence: 99%

Hemodynamic investigation of a novel rotary displacement blood pump for extracorporeal membrane oxygenation

Xue

Ren

Gao

et al. 2023

Numer Methods Biomed Eng

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Extracorporeal membrane oxygenation (ECMO) is a life support system used in the treatment of severe respiratory and circulatory failure. High shear stress caused by the high rotational speed of centrifugal blood pumps can cause hemolysis and platelet activation, which are among the major factors leading to the complications of the ECMO system. In this study, a novel blood pump named rotary displacement blood pump (RDBP), which can considerably reduce rotational speed and shear stress while ensuring the normal pressure flow relationship, was proposed. We employed computational fluid dynamics (CFD) analysis to investigate the performance of RDBP under adult ECMO support operating conditions (5 L/min with 350 mmHg). The efficiency and H‐Q curves of the RDBP were calculated to evaluate its hydraulic performance, and pressure, flow patterns, and shear stress distribution were analyzed to estimate the hemodynamic characteristics in the pump. In addition, the modified index of hemolysis (MIH) was calculated for the RDBP based on a Eulerian approach. The hydraulic efficiency of the RDBP was 47.28%. The velocity distribution of flow field in the pump was relatively uniform. Most of the liquid (more than 75%) in the pump was exposed to low scale shear stress (<1 Pa), which was close to normal physiological conditions. The gap area was the main distribution location of high scale shear stress. The high wall shear stress (>9 Pa) volume fraction of the RDBP was small and located in the boundary areas between the rotor's edge and the housing. The MIH value of the RDBP was 9.87 ± 0.93 (mean ± SD). The RDBP can achieve better hydraulic efficiency and hemodynamic performance at lower rotational speed. The design of this novel pump is expected to provide a new direction for developing a blood pump for ECMO.

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Section: Resultsmentioning

confidence: 99%

Hemodynamic investigation of a novel rotary displacement blood pump for extracorporeal membrane oxygenation

Xue

Ren

Gao

et al. 2023

Numer Methods Biomed Eng

Self Cite

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“…Various surgical techniques have been developed for managing diverticulum, including U-clip application, resurfacing methods, and endoluminal coil embolization (5,(23)(24)(25)(26)(27)(28). Chua et al (25) introduced an innovative approach that uses an inferiorly based periosteal flap to address diverticula extending into the subcutaneous tissue.…”

Section: Discussionmentioning

confidence: 99%

Resurfacing Dehiscence(s) Without Reducing Diverticulum Effectively Silences Pulsatile Tinnitus: Novel Surgical Techniques for Diverticulum and Intraoperative Microphone Monitoring

Hsieh,

Gao,

Chen

et al. 2023

Otol Neurotol

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Objective To emphasize the surgical importance of addressing dehiscence over diverticulum in resolving pulsatile tinnitus (PT) in patients with sigmoid sinus wall anomalies (SSWAs) and investigate anatomical differences. Study Design Retrospective data analysis. Setting Multi-institutional tertiary university medical centers. Patients Fifty participants (dehiscence/diverticulum, 29:21 cases) with SSWA-associated PT were included in the study. All 21 diverticulum participants underwent surgical intervention. Interventions 1) Surgical intervention with novel techniques monitored by intraoperative microphone. 2) Radiologic and ophthalmologic imaging methods. Main Outcome Measure(s) Quantitative and qualitative preoperative and postoperative alterations of PT and anatomical differences between dehiscence and diverticulum. Results Addressing dehiscence overlying diverticulum and sigmoid sinus wall dehiscences significantly reduced visual analog score and Tinnitus Handicap Inventory (p < 0.01). Sinus wall reconstruction led to substantial PT sound intensity reduction in the frequency range of 20 to 1000 Hz and 20 to 500 Hz (paired-sample t test, p < 0.01). Diploic vein analysis showed a significant positive correlation in 85.7% of the diverticulum cohort compared with the dehiscence cohort (p < 0.01). Eight percent of the participants exhibited papilledema, which was limited to the dehiscence cohort. Conclusion 1) Effective reduction of PT can be achieved by addressing all dehiscences, including those overlying the diverticulum, without the need to exclude the diverticulum. 2) Diploic vein may involve in the formation of diverticulum, and loss of dura mater and vascular wall thickness are observed at the SSWA locations.

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“…Polanczyk et al ( 2021 ) presented a non-invasive method of mass flow rate/velocity and wall stress analysis in type B aortic dissection by using the computer tomography angiography (CTA) and computational structural analysis. Liu et al ( 2022b ) combined the finite element method and CFD method to investigate the hemodynamic mechanism during the plug-in coil embolization in the treatment of venous diverticulum. A non-Newtonian suspended particle model was proposed to simulate the real blood flow, and the local hemodynamic characteristics of the artery containing the stent were further investigated (Wang et al 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic study of blood flow in the aorta during the interventional robot treatment using fluid–structure interaction

Zhu

Liang

et al. 2023

Biomech Model Mechanobiol

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An interventional robot is a means for vascular diagnosis and treatment, and it can perform dredging, releasing drug and operating. Normal hemodynamic indicators are a prerequisite for the application of interventional robots. The current hemodynamic research is limited to the absence of interventional devices or interventional devices in fixed positions. Considering the coupling effect of blood, vessels and robots, based on the bi-directional fluid–structure interaction, using the computational fluid dynamics and particle image velocimetry methods, combined with the sliding and moving mesh technologies, we theoretically and experimentally study the hemodynamic indicators such as blood flow lines, blood pressure, equivalent stress, deformation and wall shear stress of blood vessels when the robot precesses, rotates or does not intervene in the pulsating blood flow. The results show that the intervention of the robot increase the blood flow rate, blood pressure, equivalent stress and deformation of the vessels by 76.4%, 55.4%, 76.5%, and 346%, respectively. The operating mode of the robot during low-speed operation has little impact on the hemodynamic indicators. Using the methyl silicone oil as the experimental fluid, the elastic silicone pipe as the experimental pipe, and the intervention robot having a bioplastic outer shell, the velocity of the fluid around the robot is measured on the developed experimental device for fluid flow field in a pulsating flow when the robot runs. The experimental results are similar to the numerical results. Our work provides an important reference for the hemodynamic study and optimization of the mobile interventional devices.

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Hemodynamic mechanism of pulsatile tinnitus caused by venous diverticulum treated with coil embolization

Cited by 7 publications

References 33 publications

Hemodynamic investigation of a novel rotary displacement blood pump for extracorporeal membrane oxygenation

Hemodynamic investigation of a novel rotary displacement blood pump for extracorporeal membrane oxygenation

Resurfacing Dehiscence(s) Without Reducing Diverticulum Effectively Silences Pulsatile Tinnitus: Novel Surgical Techniques for Diverticulum and Intraoperative Microphone Monitoring

Hemodynamic study of blood flow in the aorta during the interventional robot treatment using fluid–structure interaction

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