Modelling of the arteriovenous malformation embolization optimal scenario

Cherevko, A. A.; Gologush, T. S.; Petrenko, I. A.; Остапенко, В. В.; Panarin, V. A.

doi:10.1098/rsos.191992

Cited by 4 publications

(12 citation statements)

References 41 publications

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“…Despite its simplicity, this approach is often used to simulate the filtration of blood and embolic agents through AVMs, as can be seen in a recent work by Cherevko et al, aimed at studying the optimal scenario for cerebral AVM embolization. 24 Experimental Model A simple experimental model was used to replicate in vitro the AVM fluid dynamics and embolisation effects simulated in silico.…”

Section: Contrast Agent Transport In the Avmmentioning

confidence: 99%

A Computational Framework for Pre-Interventional Planning of Peripheral Arteriovenous Malformations

Franzetti

Bonfanti

Tanade

et al. 2021

Cardiovasc Eng Tech

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Purpose Peripheral arteriovenous malformations (pAVMs) are congenital lesions characterised by abnormal high-flow, low-resistance vascular connections—the so-called nidus—between arteries and veins. The mainstay treatment typically involves the embolisation of the nidus, however the complexity of pAVMs often leads to uncertain outcomes. This study aims at developing a simple, yet effective computational framework to aid the clinical decision making around the treatment of pAVMs using routinely acquired clinical data. Methods A computational model was developed to simulate the pre-, intra-, and post-intervention haemodynamics of a patient-specific pAVM. A porous medium of varying permeability was employed to simulate the sclerosant effect on the nidus haemodynamics. Results were compared against clinical data (digital subtraction angiography, DSA, images) and experimental flow-visualization results in a 3D-printed phantom of the same pAVM. Results The computational model allowed the simulation of the pAVM haemodynamics and the sclerotherapy-induced changes at different interventional stages. The predicted inlet flow rates closely matched the DSA-derived data, although the post-intervention one was overestimated, probably due to vascular system adaptations not accounted for numerically. The nidus embolization was successfully captured by varying the nidus permeability and increasing its hydraulic resistance from 0.330 to 3970 mmHg s ml−1. The nidus flow rate decreased from 71% of the inlet flow rate pre-intervention to 1%: the flow completely bypassed the nidus post-intervention confirming the success of the procedure. Conclusion The study demonstrates that the haemodynamic effects of the embolisation procedure can be simulated from routinely acquired clinical data via a porous medium with varying permeability as evidenced by the good qualitative agreement between numerical predictions and both in vivo and in vitro data. It provides a fundamental building block towards a computational treatment-planning framework for AVM embolisation.

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Section: Contrast Agent Transport In the Avmmentioning

confidence: 99%

A Computational Framework for Pre-Interventional Planning of Peripheral Arteriovenous Malformations

Franzetti

Bonfanti

Tanade

et al. 2021

Cardiovasc Eng Tech

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“…A model of AVM embolization was proposed based on the concept of two-fluid modeling and scalar transport, where embolic agent and blood interaction along with its hardening is simulated by viscosity increase 21 . Another approach to the description of the embolization process is based on the two-phase filtration model in the authors’ work 22 . The present paper is a extension of this work.…”

Section: Introductionmentioning

confidence: 99%

“…The present paper is a extension of this work. In comparison to the present work in 22 blood flow into the adjacent healthy vessels was not considered, the cross-section area and porosity were assumed to be constant, and embolization was modeled without taking into account embolic agent solidification between the stages of surgery (simplified one-stage case). The optimal control problem 22 differs in form from the one described below, but is essentially the same, namely, it requires performing the operation in the most efficient way in compliance with safety constraints.…”

Section: Introductionmentioning

confidence: 99%

“…In comparison to the present work in 22 blood flow into the adjacent healthy vessels was not considered, the cross-section area and porosity were assumed to be constant, and embolization was modeled without taking into account embolic agent solidification between the stages of surgery (simplified one-stage case). The optimal control problem 22 differs in form from the one described below, but is essentially the same, namely, it requires performing the operation in the most efficient way in compliance with safety constraints. The formulation of the optimal control problem in present paper is obtained from the control problem 22 by interchanging the constraint and the objective functional, which is typical of extremum search problems with constraints.…”

Section: Introductionmentioning

confidence: 99%

“…The optimal control problem 22 differs in form from the one described below, but is essentially the same, namely, it requires performing the operation in the most efficient way in compliance with safety constraints. The formulation of the optimal control problem in present paper is obtained from the control problem 22 by interchanging the constraint and the objective functional, which is typical of extremum search problems with constraints. In the work 22 , the search for an extremum of the functional was based on the calculation of its value on the grid in the three-dimensional control parameter space with subsequent interpolation.…”

Section: Introductionmentioning

confidence: 99%

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Optimal control problem arising in mathematical modeling of cerebral vascular pathology embolization

Sharifullina

Cherevko

Остапенко

2022

Sci Rep

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Arteriovenous malformation (AVM) of the brain is a congenital vascular abnormality, in which the arterial and venous blood pools are intertwined and directly connected. This dangerous disease causes a high risk of intracranial hemorrhage and disrupts brain functioning. The preferred method of AVM treating is embolization, which is the endovascular filling of abnormal AVM vessels with a special embolic agent. Despite the fact that this method is widely used in neurosurgery, in some cases its use is accompanied by perioperative AVM vessels rupture. In this regard, the aim of this work is to study the optimal scenarios for multi-stage AVM embolization from the effectiveness and safety of the procedure point of view. Mathematically, the joint movement of blood and embolic agent in the AVM body is described on the basis of a one-dimensional two-phase filtration model, which takes into account the redistribution of blood to surrounding healthy vessels. For the numerical solution of the resulting integro-differential system of equations, a monotonic modification of the CABARET scheme is used. To find optimal embolization scenarios, the optimal control problem with phase constraints arising from medicine is formulated. A modified particle swarm optimization method is used to solve this problem numerically. This technique is used to obtain optimal embolization scenarios on the basis of real patients clinical data collected during neurosurgical operations.

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Idiopathic hypercalciuria presents: a precocious marker of osteoporosis

Ramirez-Esteva¹,

Malberty-Giro²

2019

MOJPH

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Epidemiological studies in the last ten years have provided that nephrolithiasis is a risk factor for development of hypertension and have higher prevalence of diabetes mellitus and some hypertensive and diabetic patients are at greater risk for stone formation in connecting with altered calcium homeostasis; likewise in these last ten years, the deficit of zinc in the serum has been associated with the diabetes mellitus and another illnesses as: hipogonodism, Cushing Syndrome, celiac illness, and renal inadequacy, that propitiate to any age the osteoporosis appearance. It was used the creative idea as analysis method of data, applying the comparison by analogy between the well-known alterations of the homeostasis of the calcium and of the zinc, and those that can take place for the interaction among them. Review the data from the selected literature by this way, shows that, as conclusions: The event idiopathic calcium oxalate nephrolithiasis it is concomitant with the idiopathic hypercalciuria; the oxidative stress may be identifying by the presence of a direct correlation in the urine between the increments of calcium (hypercalciuria) and of zinc (hyperzincuria); the presence of idiopathic hypercalciuria it may be constitutes a precocious marker of the osteoporosis.

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Modelling of the arteriovenous malformation embolization optimal scenario

Cited by 4 publications

References 41 publications

A Computational Framework for Pre-Interventional Planning of Peripheral Arteriovenous Malformations

A Computational Framework for Pre-Interventional Planning of Peripheral Arteriovenous Malformations

Optimal control problem arising in mathematical modeling of cerebral vascular pathology embolization

Idiopathic hypercalciuria presents: a precocious marker of osteoporosis

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