Mechanical Platelet Activation Potential in Abdominal Aortic Aneurysms

Hansen, Kirk B.; Arzani, Amirhossein; Shadden, Shawn C.

doi:10.1115/1.4029580

Cited by 48 publications

(38 citation statements)

References 60 publications

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“…Since its initial release, SimVascular has contributed to numerous advances in fundamental disease research, surgical planning, and medical device design [30,[45][46][47][48][49][50][51][52][53][54][55]. An accompanying publicly available data repository 4 provides patient-specific image data, models, and simulation results of over 120 clinical cases from different regions of the vasculature, including cerebrovascular, coronary, aortofemoral, pulmonary, and congenital heart disease [33,56,57].…”

Section: Introductionmentioning

confidence: 99%

A Re-Engineered Software Interface and Workflow for the Open-Source SimVascular Cardiovascular Modeling Package

Lan

Updegrove

Wilson

et al. 2018

Journal of Biomechanical Engineering

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Patient-specific simulation plays an important role in cardiovascular disease research, diagnosis, surgical planning and medical device design, as well as education in cardiovascular biomechanics. simvascular is an open-source software package encompassing an entire cardiovascular modeling and simulation pipeline from image segmentation, three-dimensional (3D) solid modeling, and mesh generation, to patient-specific simulation and analysis. SimVascular is widely used for cardiovascular basic science and clinical research as well as education, following increased adoption by users and development of a GATEWAY web portal to facilitate educational access. Initial efforts of the project focused on replacing commercial packages with open-source alternatives and adding increased functionality for multiscale modeling, fluid-structure interaction (FSI), and solid modeling operations. In this paper, we introduce a major SimVascular (SV) release that includes a new graphical user interface (GUI) designed to improve user experience. Additional improvements include enhanced data/project management, interactive tools to facilitate user interaction, new boundary condition (BC) functionality, plug-in mechanism to increase modularity, a new 3D segmentation tool, and new computer-aided design (CAD)-based solid modeling capabilities. Here, we focus on major changes to the software platform and outline features added in this new release. We also briefly describe our recent experiences using SimVascular in the classroom for bioengineering education.

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Section: Introductionmentioning

confidence: 99%

A Re-Engineered Software Interface and Workflow for the Open-Source SimVascular Cardiovascular Modeling Package

Lan

Updegrove

Wilson

et al. 2018

Journal of Biomechanical Engineering

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“…The mechanism that leads thrombus accumulation are still not well understood; While it is still uncertain whether platelets are mechanically activated 4 , or biochemical induced 23 , it is known that hemodynamic forces play an important role. Doyle and colleagues 11 , by using a patient-specific geometry of one patient observed that the regions where the AAA expanded coincided with the regions of low TAWSS and ILT accumulation, which in turn was the same area that experienced ruptured.…”

Section: Introductionmentioning

confidence: 99%

Association of Intraluminal Thrombus, Hemodynamic Forces, and Abdominal Aortic Aneurysm Expansion Using Longitudinal CT Images

et al. 2015

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While hemodynamic forces and intraluminal thrombus (ILT) are believed to play important roles on abdominal aortic aneurysm (AAA), it has been suggested that hemodynamic forces and ILT also interact with each other, making it a complex problem. There is, however, a pressing need to understand relationships among three factors: hemodynamics, ILT accumulation, and AAA expansion for AAA prognosis. Hence this study used longitudinal CT scans from 14 patients and analyzed the relationship between them. Hemodynamic forces, represented by wall shear stress (WSS), were obtained from computational fluid dynamics; ILT accumulation was described by ILT thickness distribution changes between consecutives scans, and ILT accumulation and AAA expansion rates were estimated from changes in ILT and AAA volume. Results showed that, while low WSS was observed at regions where ILT accumulated, the rate at which ILT accumulated occurred at the same rate as the aneurysm expansion. Comparison between AAAs with and without thrombus showed that aneurysm with ILT recorded lower values of WSS and higher values of AAA expansion than those without thrombus. Findings suggest that low WSS may promote ILT accumulation and submit the idea that by increasing WSS levels ILT accumulation may be prevented.

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“…As PAS, which represents the current state of platelet activation in Equation (), could not be initially zero, a non‐zero background level of activation for each platelet was required. A background level of 1%–20% could be used for this purpose . In the present study, to validate the numerical results against the experimental results presented by Yin et al, a background level of 1% was used as suggested by Hedayat et al because Yin et al employed apheresis units of platelets with no initial activation.…”

Section: Methodsmentioning

confidence: 82%

“…For all other simulations, a background level of 20% was employed. The purpose of using a high background level of 20% for all simulations was to incorporate the effect of multiple cardiac cycles that a platelet passes through BMHV during its lifetime as only 1 cardiac cycle was simulated in this study …”

Section: Methodsmentioning

confidence: 99%

Numerical investigation on the effect of bileaflet mechanical heart valve's implantation tilting angle and aortic root geometry on intermittent regurgitation and platelet activation

et al. 2019

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Platelet activation induced by shear stresses and non-physiological flow field generated by bileaflet mechanical heart valves (BMHVs) leads to thromboembolism, which can cause fatal consequences. One of the causes of platelet activation could be intermittent regurgitation, which arises due to asynchronous movement and rebound of BMHV leaflets during the valve closing phase. In this numerical study, the effect of intermittent regurgitation on the platelet activation potential of BMHVs was quantified by modeling a BMHV in the straight and anatomic aorta at implantation tilt angles 0°, 5°, 10°, and 20°. A fully implicit Arbitrary Lagrangian-Eulerian-based Fluid-Structure Interaction formulation was adopted with blood modeled as a multiphase, non-Newtonian fluid. Results showed that the intermittent regurgitation and consequently the platelet activation level increases with the increasing implantation tilt of BMHV. For the straight aorta, the leaflet of the 20° tilted BMHV underwent a rebound of approximately 20° after initially closing, whereas the leaflet of the 10°, 5°, and 0° tilted BMHVs underwent a rebound of 8.5°, 3°, and 0°, respectively. For the anatomic aorta, the leaflet of the 20° tilted BMHV underwent a rebound of approximately 24° after initially closing, whereas the leaflet of the 10°, 5°, and 0° tilted BMHVs underwent a rebound of 14°, 10°, and 7°, respectively. For all the implantation orientations of BMHVs, intermittent regurgitation and platelet activation were always higher in the anatomic aorta than in the straight aorta. The study concludes that the pivot axis of BMHV must be implanted parallel to the aortic root's curvature to minimize intermittent regurgitation and platelet activation. K E Y W O R D Saortic root geometry, bileaflet mechanical heart valve, implantation tilting angle, intermittent regurgitation, platelet activation

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Mechanical Platelet Activation Potential in Abdominal Aortic Aneurysms

Cited by 48 publications

References 60 publications

A Re-Engineered Software Interface and Workflow for the Open-Source SimVascular Cardiovascular Modeling Package

A Re-Engineered Software Interface and Workflow for the Open-Source SimVascular Cardiovascular Modeling Package

Association of Intraluminal Thrombus, Hemodynamic Forces, and Abdominal Aortic Aneurysm Expansion Using Longitudinal CT Images

Numerical investigation on the effect of bileaflet mechanical heart valve's implantation tilting angle and aortic root geometry on intermittent regurgitation and platelet activation

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