Experimental Insight into the Hemodynamics and Perfusion of Radiological Contrast in Patent and Non-patent Aortic Dissection Models

Salameh, Elie; Saade, Charbel; Oweis, Ghanem F.

doi:10.1007/s13239-019-00407-4

Cited by 8 publications

(6 citation statements)

References 61 publications

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“…demonstrated the importance of the size of the proximal tear and its location in predicting a patent FL and causing undesirable outcomes. Also, several studies have reported an influence of the tear size and location on the hemodynamics and the correlation to adverse outcomes (Mohr-Kahaly et al 1989;Iwai et al 1991;Tsai et al 2008;Qing et al 2012;Chen et al 2013;Rudenick et al 2013;Canchi et al 2018;Salameh et al 2019;Zadrazil et al 2020;Chung et al 2000a, b). Due to their low overall sensitivity index (Sect.…”

Section: Discussionmentioning

confidence: 99%

“…To develop our approach, we started with idealized geometries. It is known that idealized geometries provide physiologically relevant information in both 2D and 3D (Tsai et al 2008;Ben Ahmed et al 2016;Salameh et al 2019;Zadrazil et al 2020;Jafarinia et al 2020;Keramati et al 2020). In the current work, the choice of an idealized geometry was essential to allow sufficient statistics for the global sensitivity analysis.…”

Section: Discussionmentioning

confidence: 99%

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Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

Jafarinia

Melito

Müller

et al. 2023

Biomech Model Mechanobiol

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Type B aortic dissection (TBAD) carries a high risk of complications, particularly with a partially thrombosed or patent false lumen (FL). Therefore, uncovering the risk factors leading to FL thrombosis is crucial to identify high-risk patients. Although studies have shown that morphological parameters of the dissected aorta are related to FL thrombosis, often conflicting results have been reported. We show that recent models of thrombus evolution in combination with sensitivity analysis methods can provide valuable insights into how combinations of morphological parameters affect the prospect of FL thrombosis. Based on clinical data, an idealized geometry of a TBAD is generated and parameterized. After implementing the thrombus model in computational fluid dynamics simulations, a global sensitivity analysis for selected morphological parameters is performed. We then introduce dimensionless morphological parameters to scale the results to individual patients. The sensitivity analysis demonstrates that the most sensitive parameters influencing FL thrombosis are the FL diameter and the size and location of intimal tears. A higher risk of partial thrombosis is observed when the FL diameter is larger than the true lumen diameter. Reducing the ratio of the distal to proximal tear size increases the risk of FL patency. In summary, these parameters play a dominant role in classifying morphologies into patent, partially thrombosed, and fully thrombosed FL. In this study, we point out the predictive role of morphological parameters for FL thrombosis in TBAD and show that the results are in good agreement with available clinical studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

Jafarinia

Melito

Müller

et al. 2023

Biomech Model Mechanobiol

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“…AD patients, mainly the elderly, often have combined atherosclerosis and aortic vascular changes, and as a result, the aortic blood circulation resistance increases, resulting in hemodynamic change [24]. Single-phase scanning may be disrupted by these hemodynamic changes and not detect the true and false lumens, whereas multiphase aorta CTA scanning can determine the number of tears, and false lumen ow can be observed by looking at different scan periods for a change in the true and false lumen contrast agent, providing favorable imaging data for clinical treatment [25][26][27]. Dynamic CT imaging technology can be applied to vascular imaging and AD after multiphase phase reconstruction, and each level can provide multiple static images of the phase at different periods.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of dynamic computed tomographic angiography for aortic dissection and the perfusion of involved organs

Song

Lyu

Wang

et al. 2022

Preprint

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Purpose: Early diagnosis of aortic dissection (AD) and end-organ malperfusion is of great significance for AD’s management and prognosis. This study aimed to evaluate the use of aortic dynamic computed tomography (CT) angiography (CTA) in diagnosing AD and the significance of evaluating blood supply to abdominal organs. Methods: The patients with confirmed AD and who visited our hospital from 12/2018 to 12/2019 were retrospectively included. The densities of the aortas and abdominal organs were measured, and a time-density curve was drawn and compared with conventional CTA. Correlation analysis was performed between the changes of densities in the false lumen and the changes of densities in injured kidneys. Results:Fifty patients were included. The tears were seen in 86%. The main aortic branches were involved in 48%. The diagnostic rate of dynamic angiography for rupture was 86%, slightly better than aortic CTA (84%, P<0.01; κ=0.765). The density of the true and false lumens was measured in each phase: phase 2 (4%), 3 (4%), 4 (48%), 5 (26%), and 6 (16%). Eighteen patients had single renal artery involvement. In phase 7, the density of the AD false lumen and kidney damage were correlated (r=0.75, P<0.001). Conclusions: Dynamic angiography can show the fine structures of AD. In dynamic angiography, the best phase can be selected according to the hemodynamic changes of patients to complete the diagnosis. False lumen density in phase 7 was correlated with renal injury.

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“…Furthermore, Clough et al (2012) reported the presence of helical flows at different locations in the false lumen by examining images acquired with phasecontrast magnetic resonance imaging (PC-MRI) and related these helical flows to the aortic expansion rate. More recently, a few research groups are employing laser diagnostic methods to explore the haemodynamics in higher spatial and temporal resolution, using primarily particle image velocimetry (PIV) (Yip et al, 2004;Salameh et al, 2017Salameh et al, , 2019Moravia et al, 2019) and stereo-particle image velocimetry (s-PIV) (Fernandes et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

A combined experimental and computational study of the flow characteristics in a Type B aortic dissection: Effect of primary and secondary tear size

Zadrazil

Corzo

Voulgaropoulos

et al. 2020

Chemical Engineering Research and Design

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Aortic dissection is related to the separation of the tunica intima from the aortic wall, which can cause blood to flow through the newly formed lumen, thereby further damaging the torn vessel. This type of pathology is the most common catastrophic event that affects the aorta and is associated with complications such as malperfusion. In this work, an idealised, simplified geometric model of Type B aortic dissection is investigated experimentally using particle image velocimetry (PIV) and numerically using computational fluid dynamic (CFD) simulations. The flow characteristics through the true and false lumina are investigated parametrically over a range of tear sizes. Specifically, four different tear sizes and size ratios are considered, each representing a different dissection case or stage, and the experimental and numerical results of the flow-rate profiles through the two lumina in each case, along with the phase-averaged velocity vector maps at mid-acceleration, mid-deceleration, relaminarisation and peak systole, and their corresponding velocity profiles are compared. The experimental and numerical results are in good qualitative as well as quantitative agreement. The flow characteristics found here provide insight into the importance of the re-entry tear. We observe that an increase in the re-entry tear size increases considerably the flow rate in the false lumen, decreases significantly the wall shear stress (WSS) and decreases the pressure difference between the false and the true lumen. On the contrary, an increase in the entry tear, increases the flow rate through the false lumen, increases slightly the WSS and increases the pressure difference between the false and the true lumen. These are crucial findings that can help interpret medical diagnosis and accelerate prevention and treatment, especially in high-risk patients.

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Experimental Insight into the Hemodynamics and Perfusion of Radiological Contrast in Patent and Non-patent Aortic Dissection Models

Cited by 8 publications

References 61 publications

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

Diagnostic value of dynamic computed tomographic angiography for aortic dissection and the perfusion of involved organs

A combined experimental and computational study of the flow characteristics in a Type B aortic dissection: Effect of primary and secondary tear size

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