The BWT technique results in improved aspiration flow rates compared with the standard deployment technique. Our clinical data show that the BWT technique is effective and safe.
Bileaflet MHVs were demonstrated to be only slightly sensitive to rotation regarding the washout performance of the TAH. The proposed numerical washout model proved to be an adequate tool to quantitatively compare different configurations and designs of the artificial organ regarding the potential for blood stagnation where experimental measurements are limited.
BACKGROUND AND PURPOSE:Intracranial aneurysm treatment by flow diverters aims at triggering intra-aneurysmal thrombosis. By combining in vitro blood experiments with particle imaging velocimetry measurements, we investigated the time-resolved thrombus formation triggered by flow diverters.
Our theoretic model allows estimating the minimal catheter diameters needed for successful mechanical thrombectomy with ADAPT, as demonstrated by the good agreement with our animal experiments. Our model will be helpful to interventionalists in avoiding selecting catheters that are likely too small to be effective.
Ischemic stroke, caused by embolism of cerebral vessels, inflicts high morbidity and mortality. Endovascular aspiration of the blood clot is an interventional technique for the recanalization of the occluded arteries. However, the hemodynamics in the Circle of Willis (CoW) are not completely understood, which results in medical misjudgment and complications during surgeries. In this study we establish a multiscale description of cerebral hemodynamics during aspiration thrombectomy. First, the CoW is modeled as a 1D pipe network on the basis of computed tomography angiography (CTA) scans. Afterwards, a vascular occlusion is placed in the middle cerebral artery and the relevant section of the CoW is transferred to a 3D computational fluid dynamic (CFD) domain. A suction catheter in different positions is included in the CFD simulations. The boundary conditions of the 3D domain are taken from the 1D domain to ensure system coupling. A Eulerian-Eulerian multiphase simulation describes the process of thrombus aspiration. The physiological blood flow in the 1D and 3D domains is validated with literature data. Further on, it is proved that domain reduction and pressure coupling at the boundaries are an appropriate method to reduce computational costs. Future work will apply the developed framework to various clinical questions.
The flow field in the respiratory and vascular system is known to be influenced by the flexibility of the walls. However, up to now, most of the experimental biofluidic investigations have been performed in rigid models due to the complexity and necessity of optical access. In this paper, a facility and measurement techniques for studying oscillating and pulsatile flow in elastic vessels will be described. The investigated vessel models have been adapted such that fluid-mechanical and structure-mechanical characteristics represent realistic blood flows in medium blood vessels. That is, characteristic parameters, i.e., the Reynolds and Womersley number, as well as mechanical properties of the flexible wall, i.e., the Young's modulus and the material compliance, have been chosen to reasonably represent realistic flow conditions. First, a method to manufacture elastic models, which mimic the structure-mechanical properties of vascular vessels is described. The models possess a tunable compliance and are made of transparent polydimethylsiloxane. Second, the experimental setup of the flow facility will be elucidated. The flow facility allows to mimic pulsatile flow at physiologically relevant Reynolds and Womersley numbers. The precise form of the flow cycle can individually be controlled. Water/glycerine is used as flow medium for refractive index matching particle image velocimetry (PIV) measurements. The PIV recordings not only allow to assess the mean cross-sectional flow field but also further enable to simultaneously detect the movement of the flexible wall. Additionally, the local wall-shear stress can be obtained from the single-pixel line resolved near-wall flow field. To confirm the flow conditions of the oscillatory laminar flow inside the flow facility and to evaluate the ability to assess the flow field, measurements in a straight, uniform diameter, rigid Plexiglas pipe under identical conditions to those of the oscillating flow in the flexible vessel have been performed. The measurements of oscillating flow in the rigid pipe corroborate the experimentally obtained flow field and the wall-shear stress to well confirm Womersley's analytical solution and thereby evidence the quality of the flow facility and of the measurement techniques. To further study the detectability of the vessel deformation, oscillating flow at Reynolds numbers based on the non-dilated vessel diameter D and peak velocities Re D ranging from 1,000 to 1,750 and at Womersley numbers a ranging from 5 to 17.5 has been investigated in an elastic vessel.
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