Flow and wall shear stress characterization after endovascular aneurysm repair and endovascular aneurysm sealing in an infrarenal aneurysm model

Boersen, Johannes T.; Jebbink, Erik Groot; Versluis, Michel; Slump, Cornelis H.; Ku, David N.; Vries, Jean‐Paul P.M. de; Reijnen, Michel M.P.J.

doi:10.1016/j.jvs.2016.10.077

Cited by 28 publications

(22 citation statements)

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“…In AA aneurysms, changes in flow patterns modulate inflammatory mechanisms in the vascular endothelium, causing aneurysm growth [4]. For AA aneurysms and stenotic lesions around the aortic bifurcation, in vitro data have shown that different treatment options generate different flow perturbations [5], [6], which can partly explain the different outcomes of these treatments. Post-treatment analysis of AA blood-flow patterns may make the follow-up schemes after endovascular treatment more patient-specific by predicting potential failure.…”

Section: Introductionmentioning

confidence: 99%

High-Frame-Rate Contrast-Enhanced Ultrasound for Velocimetry in the Human Abdominal Aorta

Voorneveld

Engelhard

Vos

et al. 2018

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Treatment of abdominal aortic (AA) aneurysms and stenotic lesions may be improved by analyzing their associated blood flow patterns. Angle-independent blood flow patterns in the AA can be obtained by combining echo-particle image velocimetry (ePIV) with high frame rate contrast-enhanced ultrasonography. However, ePIV performance is affected by ultrasound contrast agent (UCA) concentration, microbubble stability and tissue clutter. In this study we assessed the influence of acoustic pressure and UCA concentration on image quality for ePIV analysis. We also compared amplitude modulation (AM) and singular value decomposition (SVD) as tissue suppression strategies for ePIV. Fourteen healthy volunteers were imaged in the region of the distal AA. We tested four different UCA bolus volumes (0.25, 0.5, 0.75 and 1.5 ml) and four different acoustic output pressures (mechanical indices: 0.01, 0.03, 0.06 and 0.09). As image quality metrics, we measured contrast-to-background ratio, bubble disruption ratio and maximum normalized cross-correlation value during ePIV. At mechanical indices ≥ 0.06, we detected severe bubble destruction, suggesting that very low acoustic pressures should be used for ePIV. SVD was able to suppress tissue clutter better than AM. The maximum tracking correlation was affected by both UCA concentration and flow rate, where at high flow rates, lower UCA concentrations resulted in slightly higher correlation values but more signal drop-outs during late diastole. High frame rate ePIV was successfully performed in the AA of healthy volunteers and shows promise for future studies in patients.

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Section: Introductionmentioning

confidence: 99%

High-Frame-Rate Contrast-Enhanced Ultrasound for Velocimetry in the Human Abdominal Aorta

Voorneveld

Engelhard

Vos

et al. 2018

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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“…The main advantage of this novel pump compared with other commercially available pumps is its simplicity in generating the peripheral flow profiles. Traditionally, two needle valves located at renal artery outlets, an air chamber and a needle valve in series located at the combined common iliac artery outlets representing a twoelement Windkessel were used 1,2,17,18 to simulate the vessel resistance and peripheral compliance in order to generate flow profile with reverse flow in the early diastolic phase. With the reciprocating roller pump design, it can produce back flow in the peripheral artery without the use of renal artery flow in the circuit, therefore it simplifies the flow circuit for in vitro studies involving infrarenal aorta, iliac, femoral, and other peripheral arteries.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it has been successfully used by researchers to study and validate new treatment methods such as minimally invasive endovascular stent treatments. 1,2 In addition,…”

Section: Introductionmentioning

confidence: 99%

“…Previous devices can be classified according to the type of pumps used in the setup that is, gear, piston, or roller/peristaltic. Gear pumps have been used by Groot Jebbink et al, 1 Boersen et al, 2 and Hoskins 8 to generate the pulsatile waveforms. However, the disadvantage of gear pumps is that suspended particles are easily damaged and it is sensitive to cavitation produced by the hydrodynamic action of the gears.…”

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A novel roller pump for physiological flow

et al. 2020

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“…In addition, the oscillatory shear index is the mean fluctuation of wall shear stress vectors during the cardiac cycle, and a higher oscillatory shear index indicates that the wall shear stress vectors are substantially fluctuating. A high oscillatory shear index is also an important indicator of vascular remodeling, aneurysm progression, and rupture risk . Bürk et al reported a low wall shear stress and high oscillatory shear index in patients with a dilated thoracic aorta compared with healthy controls .…”

Section: Discussionmentioning

confidence: 99%

Certain aortic geometries and hemodynamics are associated with FID development and impact the evolution of uncomplicated type B intramural hematoma during the acute phase

et al. 2019

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Objectives It is difficult to predict the evolution of uncomplicated type B intramural hematoma (IMHB) with a focal intimal disruption (FID) in the acute phase. The aims of this study were to investigate the predictors of FIDs and summarize the risk factors for the evolution of uncomplicated IMHB in the acute phase. Methods Eighty‐six patients with uncomplicated IMHB were included and were divided according to the development of an FID during the acute phase: the FID group (n = 32) and the no‐FID group (n = 54). Geometric measurements and computed fluid dynamic calculations were based on a computed tomography scan performed on admission. Multivariate logistic regression analysis was used to estimate the predictors of FID development. Results Thirty‐two (37%) patients developed an FID. Patients with an FID had higher C‐reactive protein levels (18.6 ± 2.3 vs 8.1 ± 0.2 mg/dL, P < 0.001) and white blood cell counts (10.3 ± 2.1 vs 7.5 ± 1.7 109/L, P < 0.001). The no‐FID group had lower occurrences of disease progression (15% vs 64%, P < 0.001) and aorta‐related mortality (6% vs 25%, P = 0.016). Multivariate logistic regression analysis indicated a significant risk for the occurrence of an FID with a larger maximum aortic diameter (OR, 1.35; 95% CI, 1.05‐1.73, P = 0.020), thicker hematoma (OR, 2.20; 95% CI, 1.40‐3.48, P = 0.001), and higher oscillatory shear index (per 0.01 unit, OR, 1.74; 95% CI, 1.21‐2.49, P = 0.003). The aorta‐related mortality during the acute phase was 25% (n = 8). Conclusions Certain aortic conditions, including ta larger aortic diameter, thicker hematoma and higher oscillatory shear stress, are associated with the FID development and result in worse clinical outcomes.

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Flow and wall shear stress characterization after endovascular aneurysm repair and endovascular aneurysm sealing in an infrarenal aneurysm model

Abstract: The different stent designs do not influence suprarenal flow. Lower WSS is observed in the caudal wall of the RA after EVAR and a higher shear rate after EVAS. All stented models have a small region of low WSS and high OSI near the distal outflow of the stents.

Cited by 28 publications

References 28 publications

High-Frame-Rate Contrast-Enhanced Ultrasound for Velocimetry in the Human Abdominal Aorta

High-Frame-Rate Contrast-Enhanced Ultrasound for Velocimetry in the Human Abdominal Aorta

A novel roller pump for physiological flow

Certain aortic geometries and hemodynamics are associated with FID development and impact the evolution of uncomplicated type B intramural hematoma during the acute phase

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