Cardiovascular Engineering and Technology最新文献

{"title":"\"What makes blood clots break off?\" A Back-of-the-Envelope Computation Toward Explaining Clot Embolization.","authors":"Osman Gültekin, Matthew J Lohr, Grace N Bechtel, Manuel K Rausch","doi":"10.1007/s13239-024-00733-2","DOIUrl":"10.1007/s13239-024-00733-2","url":null,"abstract":"<p><strong>Purpose: </strong>One in four deaths worldwide is due to thromboembolic disease; that is, one in four people die from blood clots first forming and then breaking off or embolizing. Once broken off, clots travel downstream, where they occlude vital blood vessels such as those of the brain, heart, or lungs, leading to strokes, heart attacks, or pulmonary embolisms, respectively. Despite clots' obvious importance, much remains to be understood about clotting and clot embolization. In our work, we take a first step toward untangling the mystery behind clot embolization and try to answer the simple question: \"What makes blood clots break off?\"</p><p><strong>Methods: </strong>To this end, we conducted experimentally-informed, back-of-the-envelope computations combining fracture mechanics and phase-field modeling. We also focused on deep venous clots as our model problem.</p><p><strong>Results: </strong>Here, we show that of the three general forces that act on venous blood clots-shear stress, blood pressure, and wall stretch-induced interfacial forces-the latter may be a critical embolization force in occlusive and non-occlusive clots, while blood pressure appears to play a determinant role only for occlusive clots. Contrary to intuition and prior reports, shear stress, even when severely elevated, appears unlikely to cause embolization.</p><p><strong>Conclusion: </strong>This first approach to understanding the source of blood clot bulk fracture may be a critical starting point for understanding blood clot embolization. We hope to inspire future work that will build on ours and overcome the limitations of these back-of-the-envelope computations.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"584-593"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a High-Fidelity Benchtop Model for Simultaneous Flow, Pressure, and Imaging Assessment of Transarterial Embolization Procedures","authors":"Prateek C. Gowda, Robert M. Weinstein, Akanksha Bhargava, Janaka Senarathna, Ryan Q. Stewart, Pallavi V. Ekbote, Mantej Singh, Emily Guan, Serena Banghar, Arvind P. Pathak, Clifford R. Weiss","doi":"10.1007/s13239-024-00749-8","DOIUrl":"https://doi.org/10.1007/s13239-024-00749-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The development of new endovascular technologies for transarterial embolization has relied on animal studies to validate efficacy before clinical trials are undertaken. Because embolizations in animals and patients are primarily conducted with fluoroscopy alone, local hemodynamic changes are not assessed during testing. However, such hemodynamic metrics could be important indicators of procedure efficacy that could support improved patient outcomes, such as via the determination of procedural endpoints. The purpose of this study is to create a high-fidelity benchtop system for multiparametric (i.e., hemodynamic and imaging) assessment of transarterial embolization procedures.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The benchtop system consists of a 3D printed, anatomically accurate vascular phantom; a flow loop with a cardiac output simulator; a high-speed video camera; and pressure transducers and flow meters. This system enabled us to vary the heart rate and blood pressure and to simulate clinically relevant hemodynamic states, such as healthy adult, aortic regurgitation, and hypovolemic shock.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>With our radiation-free angiography-mimetic imaging system, we could simultaneously assess gauge pressure and flow values during transarterial embolization. We demonstrated the feasibility of recapitulating the digital subtraction angiography workflow. Finally, we highlighted the utility of this system by characterizing the relationship between an imaging-based metric of procedural endpoint and intravascular flow. We also characterized hemodynamic changes associated with particle embolization within a branch of the hepatic artery and found them to be within reported patient data.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Our benchtop vascular system was low-cost and reproduced transarterial embolization-related hemodynamic phenomena with high fidelity. We believe that this novel platform enables the characterization of patient physiology, novel catheterization devices, and techniques.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"11 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benchtop Flow Stasis Quantification: In Vitro Methods and In Vivo Possibilities","authors":"Vahid Sadri, Prem A. Midha, Immanuel David Madukauwa-David, Norihiko Kamioka, Phillip M. Trusty, Priya J. Nair, Samuel Cohen, Vrishank Raghav, Rahul Sharma, Vasilis Babaliaros, Ajit P. Yoganathan","doi":"10.1007/s13239-024-00750-1","DOIUrl":"https://doi.org/10.1007/s13239-024-00750-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Neo-sinus flow stasis has ben correlated with transcatheter heart valve (THV) thrombosis severity and occurrence. Standard benchtop flow field quantification techniques require optical access or modified prosthesis models that may not reflect the true nature of the original valve. <i>En face</i> and fluoroscopic videodensitometry enable visualization of washout in regions otherwise unviewable.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This study compares two in vitro methods of assessing flow stasis in scenarios with insufficient optical access for traditional techniques such as particle image velocimetry (PIV). A series of seven paired experiments were conducted using a previously described laser-enhanced video densitometry (LEVD) and fluoroscopic video densitometry (FVD). Both sets of experiments were analyzed to calculate washout time as a measure of flow stasis. A novel flow stasis measure termed contrast attenuation ratio (CAR) is proposed as a viable single measure of flow stasis obtainable from only a small number of cardiac cycles of in vitro or in vivo fluoroscopic data. Retrospective fluoroscopic datasets (<i>n</i> = 72) were analyzed to assess the feasibility of obtaining this metric from routine clinical practice and its ability to stratify results.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Neo-sinus flow stasis calculated from in vitro fluoroscopy was well correlated with LEVD (r² = 0.77, <i>p</i> = 0.009). The newly proposed CAR metric showed good agreement with the commonly used “washout time” measure of flow stasis (r² = 0.91, <i>p</i> &lt; 0.001) while allowing for assessment with incomplete or truncated data. As a proof of concept, CAR was measured in 72 consecutive retrospective fluoroscopic datasets. CAR averaged 10.6 ± 4.6% with a range of 1.5–20.3% in these patients.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>This study demonstrates two in vitro methods that can be used to assess relative flow stasis in otherwise optically inaccessible regions surrounding cardiac or vascular implants. In addition, the fluoroscopic benchtop technique was used to validate a metric that allows for extension to routine clinical fluoroscopy. This contrast attenuation ratio (CAR) metric was found to be both accurate and clinically obtainable, and potentially offers a new method for valve thrombosis risk stratification.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"1 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Modulation of Pulmonary Artery Shear Stress: A Patient-Specific CFD Analysis of the Norwood Procedure.","authors":"Simbarashe G Chidyagwai, Michael S Kaplan, Christopher W Jensen, James S Chen, Reid C Chamberlain, Kevin D Hill, Piers C A Barker, Timothy C Slesnick, Amanda Randles","doi":"10.1007/s13239-024-00724-3","DOIUrl":"10.1007/s13239-024-00724-3","url":null,"abstract":"<p><strong>Purposr: </strong>This study created 3D CFD models of the Norwood procedure for hypoplastic left heart syndrome (HLHS) using standard angiography and echocardiogram data to investigate the impact of shunt characteristics on pulmonary artery (PA) hemodynamics. Leveraging routine clinical data offers advantages such as availability and cost-effectiveness without subjecting patients to additional invasive procedures.</p><p><strong>Methods: </strong>Patient-specific geometries of the intrathoracic arteries of two Norwood patients were generated from biplane cineangiograms. \"Virtual surgery\" was then performed to simulate the hemodynamics of alternative PA shunt configurations, including shunt type (modified Blalock-Thomas-Taussig shunt (mBTTS) vs. right ventricle-to-pulmonary artery shunt (RVPAS)), shunt diameter, and pulmonary artery anastomosis angle. Left-right pulmonary flow differential, Q_p/Q_s, time-averaged wall shear stress (TAWSS), and oscillatory shear index (OSI) were evaluated.</p><p><strong>Results: </strong>There was strong agreement between clinically measured data and CFD model output throughout the patient-specific models. Geometries with a RVPAS tended toward more balanced left-right pulmonary flow, lower Q_p/Q_s, and greater TAWSS and OSI than models with a mBTTS. For both shunt types, larger shunts resulted in a higher Q_p/Q_s and higher TAWSS, with minimal effect on OSI. Low TAWSS areas correlated with regions of low flow and changing the PA-shunt anastomosis angle to face toward low TAWSS regions increased TAWSS.</p><p><strong>Conclusion: </strong>Excellent correlation between clinically measured and CFD model data shows that 3D CFD models of HLHS Norwood can be developed using standard angiography and echocardiographic data. The CFD analysis also revealed consistent changes in PA TAWSS, flow differential, and OSI as a function of shunt characteristics.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"431-442"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Literature Survey for In-Vivo Reynolds and Womersley Numbers of Various Arteries and Implications for Compliant In-Vitro Modelling.","authors":"P N Williamson, P D Docherty, M Jermy, B M Steven","doi":"10.1007/s13239-024-00723-4","DOIUrl":"10.1007/s13239-024-00723-4","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"418-430"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of a Biaxial Testing System for Characterization of Right Ventricle Viscoelasticity Under Physiological Loadings.","authors":"Kellan Roth, Wenqiang Liu, Kristen LeBar, Matt Ahern, Zhijie Wang","doi":"10.1007/s13239-024-00722-5","DOIUrl":"10.1007/s13239-024-00722-5","url":null,"abstract":"<p><strong>Purpose: </strong>Prior studies have indicated an impact of cardiac muscle viscoelasticity on systolic and diastolic functions. However, the studies of ventricular free wall viscoelasticity, particularly for that of right ventricles (RV), are limited. Moreover, investigations on ventricular passive viscoelasticity have been restricted to large animals and there is a lack of data on rodent species. To fill this knowledge gap, this study aims to develop a biaxial tester that induces high-speed physiological deformations to characterize the passive viscoelasticity of rat RVs.</p><p><strong>Methods: </strong>The biaxial testing system was fabricated so that planar deformation of rat ventricle tissues at physiological strain rates was possible. The testing system was validated using isotropic polydimethylsiloxane (PDMS) sheets. Next, viscoelastic measurements were performed in healthy rat RV free walls by equibiaxial cyclic sinusoidal loadings and stress relaxation.</p><p><strong>Results: </strong>The biaxial tester's consistency, accuracy, and stability was confirmed from the PDMS samples measurements. Moreover, significant viscoelastic alterations of the RV were found between sub-physiological (0.1 Hz) and physiological frequencies (1-8 Hz). From hysteresis loop analysis, we found as the frequency increased, the elasticity and viscosity were increased in both directions. Interestingly, the ratio of storage energy to dissipated energy (W_d/W_s) remained constant at 0.1-5 Hz. We did not observe marked differences in healthy RV viscoelasticity between longitudinal and circumferential directions.</p><p><strong>Conclusion: </strong>This work provides a new experimental tool to quantify the passive, biaxial viscoelasticity of ventricle free walls in both small and large animals. The dynamic mechanical tests showed frequency-dependent elastic and viscous behaviors of healthy rat RVs. But the ratio of dissipated energy to stored energy was maintained between frequencies. These findings offer novel baseline information on the passive viscoelasticity of healthy RVs in adult rats.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"405-417"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact Exploration of Spatiotemporal Feature Derivation and Selection on Machine Learning-Based Predictive Models for Post-Embolization Cerebral Aneurysm Recanalization.","authors":"Jing Liao, Kouichi Misaki, Jiro Sakamoto","doi":"10.1007/s13239-024-00721-6","DOIUrl":"10.1007/s13239-024-00721-6","url":null,"abstract":"<p><strong>Purpose: </strong>To enhance the performance of machine learning (ML) models for the post-embolization recanalization of cerebral aneurysms, we evaluated the impact of hemodynamic feature derivation and selection method on six ML algorithms.</p><p><strong>Methods: </strong>We utilized computational fluid dynamics (CFD) to simulate hemodynamics in 66 cerebral aneurysms from 65 patients, including 57 stable and nine recanalized aneurysms. We derived a total of 107 features for each aneurysm, encompassing four clinical features, 12 morphological features, and 91 hemodynamic features. To investigate the influence of feature derivation and selection methods on the ML models, we employed two derivation methods, simplified and fully derived, in combination with four selection methods: all features, statistically significant analysis, stepwise multivariate logistic regression analysis (stepwise-LR), and recursive feature elimination (RFE). Model performance was assessed using the area under the receiver operating characteristic curve (AUROC) and precision-recall curve (AUPRC) on both the training and testing datasets.</p><p><strong>Results: </strong>The AUROC values on the testing dataset exhibited a wide-ranging spectrum, spanning from 0.373 to 0.863. Fully derived features and the RFE selection method demonstrated superior performance in intra-model comparisons. The multi-layer perceptron (MLP) model, trained with RFE-selected fully derived features, achieved the best performance on the testing dataset, with an AUROC value of 0.863 (95% CI: 0.684- 1.000).</p><p><strong>Conclusion: </strong>Our study demonstrated the importance of feature derivation and selection in determining the performance of ML models. This enabled the development of accurate decision-making models without the need to invade the patient.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"394-404"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized Bench Test Evaluation of Biomechanical Characteristics of Stents Used in Right Ventricular Outflow Tract Revalvulation.","authors":"Pierre-Guillaume Piriou, Julien Plessis, Thibaut Manigold, Vincent Letocart, Robin Le Ruz, Paul Padovani, Patrice Guérin","doi":"10.1007/s13239-024-00726-1","DOIUrl":"10.1007/s13239-024-00726-1","url":null,"abstract":"<p><strong>Purpose: </strong>Pre-stenting of the right ventricular outflow tract (RVOT) is commonly performed before percutaneous pulmonary valve implantation (PPVI), to relieve obstruction, prevent valved stent fractures, and provide a landing zone. This study aimed to evaluate the biomechanical characteristics of the stents currently used to perform pre-stenting of the RVOT.</p><p><strong>Methods: </strong>We assessed five commercially available stents: Cheatham-Platinum Stent (\"CP Stent\"), AndraStent XL, AndraStent XXL, Optimus XL, and Optimus XXL. Following stent deployment at nominal pressure, radial and longitudinal elastic recoils and radial resistance were measured. The bending stiffness of the stents crimped onto the balloons was also evaluated.</p><p><strong>Results: </strong>Three samples were tested for each stent. Our study showed no significant difference between the stent platforms in terms of radial elastic recoil, which was relatively low (< 10%). The longitudinal elastic recoil was also low for all the devices (< 5%). Significant differences were observed in radial resistance (P < 0.001). CP Stent and AndraStent XL exhibited the highest radial resistances. The bending stiffnesses of the stents crimped on their balloons were significantly different (P < 0.00001). Optimus XL and XXL were more flexible than the other stents.</p><p><strong>Conclusion: </strong>This study highlights the significant differences between the stents currently used in RVOT pre-stenting. Stents with good radial resistance are preferred, especially for calcified vessels, and flexibility is crucial for tortuous vessels. We proposed an algorithm for selecting the most suitable stent according to the need for radial force and flexibility, which will help inform clinicians considering RVOT revalvulation.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"443-450"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Entire Mitral Valve Reconstruction Using Porcine Extracellular Matrix: Adding a Ring Annuloplasty.","authors":"Johannes H Jedrzejczyk, Stine Krog, Søren N Skov, Karen B Poulsen, Mona Sharghbin, Leila L Benhassen, Sten L Nielsen, J Michael Hasenkam, Marcell J Tjørnild","doi":"10.1007/s13239-024-00727-0","DOIUrl":"10.1007/s13239-024-00727-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the implications of inserting a flexible annuloplasty ring after reconstructing the entire mitral valve in a porcine model using a previously investigated tube graft design made of 2-ply small intestinal submucosa extracellular matrix (CorMatrix®).</p><p><strong>Methods: </strong>An acute model with eight 80-kg pigs, each acting as its own control, was used. The entire mitral valve was reconstructed with a 2-ply small intestinal submucosa extracellular matrix tube graft (CorMatrix®). Subsequently, a Simulus® flexible ring was inserted. The characterization was based on mitral annular geometry and valvular dynamics with sonomicrometry and echocardiography.</p><p><strong>Results: </strong>After adding the ring annuloplasty, the in-plane annular dynamics were more constant throughout the cardiac cycle compared to the reconstruction alone. However, the commissure-commissure distance was statistically significantly decreased [35.0 ± 3.4 mm vs. 27.4 ± 1.9 mm, P < 0.001, diff =  - 7.6 mm, 95% CI, - 9.8 to (-5.4) mm] after ring insertion, changing the physiological annular D-shape into a circular shape which created folds at the coaptation zone resulting in a central regurgitant jet on color Doppler.</p><p><strong>Conclusion: </strong>We successfully reconstructed the entire mitral valve using 2-ply small intestinal submucosal extracellular matrix (CorMatrix®) combined with a flexible annuloplasty. The annuloplasty reduced the unphysiological systolic widening previously found with this reconstructive technique. However, the Simulus flex ring changed the physiological annular D-shape into a circular shape and hindered a correct unfolding of the leaflets. Thus, we do not recommend a flexible ring in conjunction with this reconstructive technique; further investigations are needed to discover a more suitable remodelling annuloplasty.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"451-462"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Approaches and Methods to Understand Acute Ischemic Stroke Treatment Using Aspiration Thrombectomy.","authors":"Priyanka Patki, Scott Simon, Francesco Costanzo, Keefe B Manning","doi":"10.1007/s13239-024-00735-0","DOIUrl":"10.1007/s13239-024-00735-0","url":null,"abstract":"<p><p>Acute ischemic stroke occurs when a blood clot occludes a cerebral artery. Mechanical interventions, primarily stent retrievers and aspiration thrombectomy, are used currently for removing the occluding clot and restoring blood flow. Aspiration involves using a long catheter to traverse the cerebral vasculature to reach the blood clot, followed by application of suction through the catheter bore. Aspiration is also used in conjunction with other techniques such as stent retrievers and balloon guide catheters. Despite the wide use of aspiration, our physical understanding of the process and the causes of the failure of aspiration to retrieve cerebral clots in certain scenarios is not well understood. Experimental and computational studies can help develop the capability to provide deeper insights into the procedure and enable development of new devices and more effective treatment methods. We recapitulate the aspiration-based thrombectomy techniques in clinical practice and provide a perspective of existing engineering methods for aspiration. We articulate the current knowledge gap in the understanding of aspiration and highlight possible directions for future engineering studies to bridge this gap, help clinical translation of engineering studies, and develop new patient-specific stroke therapy.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"481-502"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}