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Hoving AM, Mikhal J, Kuipers H, de Borst GJ, Slump CH. Development of an in vitro setup for flow studies in a stented carotid artery bifurcation. Med Biol Eng Comput 2024; 62:1165-1176. [PMID: 38155315 DOI: 10.1007/s11517-023-02977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023]
Abstract
To investigate flow conditions in a double-layered carotid artery stent, a bench-top in vitro flow setup including a bifurcation phantom was designed and fabricated. The geometry of the tissue-mimicking phantom was based on healthy individuals. Two identical phantoms were created using 3D-printing techniques and molding with PVA-gel. In one of them, a clinically available CGuard double-layer stent was inserted. Measurements were performed using both continuous and pulsatile flow conditions. Blood flow studies were performed using echoPIV: a novel ultrasound-based technique combined with particle image velocimetry. A maximum deviation of 3% was visible between desired and measured flow patterns. The echoPIV measurements showed promising results on visualization and quantification of blood flow in and downstream the stent. Further research could demonstrate the effects of a double-layered stent on blood flow patterns in a carotid bifurcation in detail.
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Affiliation(s)
- Astrid M Hoving
- Robotics and Mechatronics Group, TechMed Centre, University of Twente, 7500 AE, Enschede, The Netherlands.
| | - Julia Mikhal
- Health Technology and Services Research Group, TechMed Centre, University of Twente, 7500 AE, Enschede, The Netherlands
| | - Henny Kuipers
- Robotics and Mechatronics Group, TechMed Centre, University of Twente, 7500 AE, Enschede, The Netherlands
| | - Gert J de Borst
- Department of Vascular Surgery, University Medical Centre Utrecht, 3584 CX, Utrecht, The Netherlands
| | - Cornelis H Slump
- Robotics and Mechatronics Group, TechMed Centre, University of Twente, 7500 AE, Enschede, The Netherlands
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Williamson PN, Docherty PD, Jermy M, Steven BM. Literature Survey for In-Vivo Reynolds and Womersley Numbers of Various Arteries and Implications for Compliant In-Vitro Modelling. Cardiovasc Eng Technol 2024:10.1007/s13239-024-00723-4. [PMID: 38499933 DOI: 10.1007/s13239-024-00723-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/19/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE In-vitro modelling can be used to investigate haemodynamics of arterial geometry and stent implants. However, in-vitro model fidelity relies on precise matching of in-vivo conditions. In pulsatile flow, velocity distribution and wall shear stress depend on compliance, and the Reynolds and Womersley numbers. However, matching such values may lead to unachievable tolerances in phantom fabrication. METHODS Published Reynolds and Womersley numbers for 14 major arteries in the human body were determined via a literature search. Preference was given to in-vivo publications but in-vitro and in-silico values were presented when in-vivo values were not found. Subsequently ascending aorta and carotid artery case studies were presented to highlight the limitations dynamic matching would apply to phantom fabrication. RESULTS Seven studies reported the in-vivo Reynolds and Womersley numbers for the aorta and two for the carotid artery. However, only one study each reported in-vivo numbers for the remaining ten arteries. No in-vivo data could be found for the femoral, superior mesenteric and renal arteries. Thus, information derived in-vitro and in-silico were provided instead. The ascending aorta and carotid artery models required scaling to 1.5× and 3× life-scale, respectively, to achieve dimensional tolerance restrictions. Modelling the ascending aorta with the comparatively high viscosity water/glycerine solution will lead to high pump power demands. However, all the working fluids considered could be dynamically matched with low pump demand for the carotid model. CONCLUSION This paper compiles available human haemodynamic information, and highlights the paucity of information for some arteries. It also provides a method for optimal in-vitro experimental configuration.
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Affiliation(s)
- P N Williamson
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
| | - P D Docherty
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand.
- Institute of Technical Medicine, Furtwangen University, Campus Villingen-Schwenningen, Jakob-Kienzle Strasse 17, 78054, Villingen-Schwenningen, Germany.
| | - M Jermy
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
| | - B M Steven
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
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Hosseinzadeh E, Bosques-Palomo B, Carmona-Arriaga F, Fabiani MA, Aguirre-Soto A. Fabrication of Soft Transparent Patient-Specific Vascular Models with Stereolithographic 3D printing and Thiol-Based Photopolymerizable Coatings. Macromol Rapid Commun 2024; 45:e2300611. [PMID: 38158746 DOI: 10.1002/marc.202300611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/03/2023] [Indexed: 01/03/2024]
Abstract
An ideal vascular phantom should be anatomically accurate, have mechanical properties as close as possible to the tissue, and be sufficiently transparent for ease of visualization. However, materials that enable the convergence of these characteristics have remained elusive. The fabrication of patient-specific vascular phantoms with high anatomical fidelity, optical transparency, and mechanical properties close to those of vascular tissue is reported. These final properties are achieved by 3D printing patient-specific vascular models with commercial elastomeric acrylic-based resins before coating them with thiol-based photopolymerizable resins. Ternary thiol-ene-acrylate chemistry is found optimal. A PETMP/allyl glycerol ether (AGE)/polyethylene glycol diacrylate (PEGDA) coating with a 30/70% AGE/PEGDA ratio applied on a flexible resin yielded elastic modulus, UTS, and elongation of 3.41 MPa, 1.76 MPa, and 63.2%, respectively, in range with the human aortic wall. The PETMP/AGE/PEGDA coating doubled the optical transmission from 40% to 80%, approaching 88% of the benchmark silicone-based elastomer. Higher transparency correlates with a decrease in surface roughness from 2000 to 90 nm after coating. Coated 3D-printed anatomical replicas are showcased for pre-procedural planning and medical training with good radio-opacity and echogenicity. Thiol-click chemistry coatings, as a surface treatment for elastomeric stereolithographic 3D-printed objects, address inherent limitations of photopolymer-based additive manufacturing.
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Affiliation(s)
- Elnaz Hosseinzadeh
- School of Engineering and Sciences, Tecnologico de Monterrey, Nuevo León, Monterrey, 64849, México
| | - Beatriz Bosques-Palomo
- School of Engineering and Sciences, Tecnologico de Monterrey, Nuevo León, Monterrey, 64849, México
| | | | - Mario Alejandro Fabiani
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Nuevo León, Monterrey, 64710, México
| | - Alan Aguirre-Soto
- School of Engineering and Sciences, Tecnologico de Monterrey, Nuevo León, Monterrey, 64849, México
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Wajihah SA, Sankar DS. A review on non-Newtonian fluid models for multi-layered blood rheology in constricted arteries. ARCHIVE OF APPLIED MECHANICS = INGENIEUR-ARCHIV 2023; 93:1771-1796. [PMID: 36743075 PMCID: PMC9886544 DOI: 10.1007/s00419-023-02368-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Haemodynamics is a branch of fluid mechanics which investigates the features of blood when it flows not only via blood vessels of smaller/larger diameter, but also under normal as well as abnormal flow states, such as in the presence of stenosis, aneurysm, and thrombosis. This review aims to discuss the rheological properties of blood, geometry of constrictions, dilations and the emergence of single-layered fluid to four-layered fluid models. To discuss further the influence of the aforesaid parameters on the physiologically important flow quantities, the mathematical formulation and solution methodology of the two-layered and four layered arterial blood flow problems studied by the authors (Afiqah and Sankar in ARPN J Eng Appl Sci 15:1129--1143, 2020, Comput Methods Programs Biomed 199:105907, 2021. 10.1016/j.cmpb.2020.105907) are recalled. It should be pointed out that the increasing resistive impedance to flow in three distinct states encompassing healthy, anaemic, and diabetic demonstrates that the greater the restriction in the artery, very few blood is carried to the pathetic organs, leading to subjects' death. It is also discovered that the pulsatile nature of blood movement produces a dynamic environment that poses a slew of intriguing and unstable fluid mechanical state. It is hoped that the intriguing results gathered from this literature survey and review conducted may help the medical practitioners to forecast blood behaviour mobility in stenotic arteries. Furthermore, the physiological information gathered from the available clinical data from the literature on patients diagnosed with diabetes and anaemia may be beneficial to doctors in deciding the therapeutic procedure for treating some particular cardiovascular disease.
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Affiliation(s)
- S. Afiqah Wajihah
- Applied Mathematics and Economics Programme Area, School of Applied Sciences and Mathematics, Universiti Teknologi Brunei, Jalan Tungku Link, Gadong, Bandar Seri Begawan, BE1410 Brunei Darussalam
| | - D. S. Sankar
- Applied Mathematics and Economics Programme Area, School of Applied Sciences and Mathematics, Universiti Teknologi Brunei, Jalan Tungku Link, Gadong, Bandar Seri Begawan, BE1410 Brunei Darussalam
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Development of Custom Wall-Less Cardiovascular Flow Phantoms with Tissue-Mimicking Gel. Cardiovasc Eng Technol 2021; 13:1-13. [PMID: 34080171 PMCID: PMC8888498 DOI: 10.1007/s13239-021-00546-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/12/2021] [Indexed: 10/26/2022]
Abstract
PURPOSE Flow phantoms are used in experimental settings to aid in the simulation of blood flow. Custom geometries are available, but current phantom materials present issues with degradability and/or mimicking the mechanical properties of human tissue. In this study, a method of fabricating custom wall-less flow phantoms from a tissue-mimicking gel using 3D printed inserts is developed. METHODS A 3D blood vessel geometry example of a bifurcated artery model was 3D printed in polyvinyl alcohol, embedded in tissue-mimicking gel, and subsequently dissolved to create a phantom. Uniaxial compression testing was performed to determine the Young's moduli of the five gel types. Angle-independent, ultrasound-based imaging modalities, Vector Flow Imaging (VFI) and Blood Speckle Imaging (BSI), were utilized for flow visualization of a straight channel phantom. RESULTS A wall-less phantom of the bifurcated artery was fabricated with minimal bubbles and continuous flow demonstrated. Additionally, flow was visualized through a straight channel phantom by VFI and BSI. The available gel types are suitable for mimicking a variety of tissue types, including cardiac tissue and blood vessels. CONCLUSION Custom, tissue-mimicking flow phantoms can be fabricated using the developed methodology and have potential for use in a variety of applications, including ultrasound-based imaging methods. This is the first reported use of BSI with an in vitro flow phantom.
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Abstract
Atherosclerosis is one of the main causes of cardiovascular events, namely, myocardium infarction and cerebral stroke, responsible for a great number of deaths every year worldwide. This pathology is caused by the progressive accumulation of low-density lipoproteins, cholesterol, and other substances on the arterial wall, narrowing its lumen. To date, many hemodynamic studies have been conducted experimentally and/or numerically; however, this disease is not yet fully understood. For this reason, the research of this pathology is still ongoing, mainly, resorting to computational methods. These have been increasingly used in biomedical research of atherosclerosis because of their high-performance hardware and software. Taking into account the attempts that have been made in computational techniques to simulate realistic conditions of blood flow in both diseased and healthy arteries, the present review aims to give an overview of the most recent numerical studies focused on coronary arteries, by addressing the blood viscosity models, and applied physiological flow conditions. In general, regardless of the boundary conditions, numerical studies have been contributed to a better understanding of the development of this disease, its diagnosis, and its treatment.
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Park J, Na Y, Jang Y, Park SY, Park H. Correlation of Pre-Hypertension with Carotid Artery Damage in Middle-Aged and Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207686. [PMID: 33096848 PMCID: PMC7589827 DOI: 10.3390/ijerph17207686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022]
Abstract
The intima–media thickness (IMT), luminal diameters (LDs), flow velocities (FVs), compliance, and β-stiffness of the carotid artery (CA) are considered as independent risk factors for cardiovascular diseases (CVDs). Pre-hypertension (PHT) is also an independent CVD risk factor. This study investigated the association between CA damage (CAD) and PHT. A total of 544 adults participated; their blood pressures (BPs) and CA characteristics were measured using a mercury-free sphygmomanometer and ultrasound. Analysis of covariance (ANCOVA) was performed to assess the differences in the CA characteristics according to the BPs, multinomial logistic regression to evaluate the risk of CAD associated with PHT. In ANCOVA, the CA characteristics of PHT were significantly different from normotensive. The odds ratios (ORs) of IMTmax, LDmax, LDmin, peak-systolic FV (PFV), end-diastolic FV (EFV), PFV/LDmin, EFV/LDmax, compliance, and β-stiffness of PHT were 4.20, 2.70, 3.52, 2.41, 3.06, 3.55, 3.29, 2.02, and 1.84 times higher than those of the normotensive, respectively, in Model 2. In Model 3 adjusted for age, the ORs of LDmax, LDmin, EFV, PFV/LDmin, and EFV/LDmax of PHT were 2.10, 2.55, 1.96, 2.20, and 2.04 times higher than those of the normotensive, respectively. Therefore, the present study revealed that CAD is closely correlated with pre-hypertensive status in adults.
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Affiliation(s)
- Jinkee Park
- Department of Sport Rehabilitation, Dong-Ju College, Busan 49318, Korea;
| | - Yongseong Na
- Department of Health Science, Dong-A University, Busan 49315, Korea; (Y.N.); (Y.J.)
| | - Yunjung Jang
- Department of Health Science, Dong-A University, Busan 49315, Korea; (Y.N.); (Y.J.)
| | - Song-Young Park
- School of Health and Kinesiology, University of Nebraska Omaha, Omaha, NE 68182, USA;
| | - Hyuntae Park
- Department of Health Science, Dong-A University, Busan 49315, Korea; (Y.N.); (Y.J.)
- Institute of Convergence Bio-Health, Dong-A University, Busan 49315, Korea
- Correspondence: ; Tel.: +82-51-200-7517
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