scholarly journals A Geodesics-Based Surface Parameterization to Assess Aneurysm Progression

2016 ◽  
Vol 138 (5) ◽  
Author(s):  
Ly Phan ◽  
Katherine Courchaine ◽  
Amir Azarbal ◽  
David Vorp ◽  
Cindy Grimm ◽  
...  
Keyword(s):  
Shape Change ◽  
Strain Relaxation ◽  
Patient Specific ◽  
Transverse Diameter ◽  
Missing Information ◽  
Registration Method ◽  
Time Points ◽  
Surface Parameterization ◽  
Change Dynamics ◽  
Abdominal Aortic

Abdominal aortic aneurysm (AAA) intervention and surveillance is currently based on maximum transverse diameter, even though it is recognized that this might not be the best strategy. About 10% of patients with small AAA transverse diameters, for whom intervention is not considered, still rupture; while patients with large AAA transverse diameters, for whom intervention would have been recommended, have stable aneurysms that do not rupture. While maximum transverse diameter is easy to measure and track in clinical practice, one of its main drawbacks is that it does not represent the whole AAA and rupture seldom occurs in the region of maximum transverse diameter. By following maximum transverse diameter alone clinicians are missing information on the shape change dynamics of the AAA, and clues that could lead to better patient care. We propose here a method to register AAA surfaces that were obtained from the same patient at different time points. Our registration method could be used to track the local changes of the patient-specific AAA. To achieve registration, our procedure uses a consistent parameterization of the AAA surfaces followed by strain relaxation. The main assumption of our procedure is that growth of the AAA occurs in such a way that surface strains are smoothly distributed, while regions of small and large surface growth can be differentiated. The proposed methodology has the potential to unravel different patterns of AAA growth that could be used to stratify patient risks.

Preliminary Murine Aortic Tissue Material Properties From Pressure-Diameter Experiments

2007 ◽  
Author(s):  
Mark E. Rentschler ◽  
B. Timothy Baxter
Keyword(s):  
Material Properties ◽  
Patient Specific ◽  
Aortic Tissue ◽  
Specific Information ◽  
Transverse Diameter ◽  
Impending Rupture ◽  
Abdominal Aortic ◽  
History Of ◽  
Tissue Material ◽  
Progressive Enlargement

Abdominal aortic aneurysm (AAA) is a common and deadly problem. The aortic diameter increases in association with a complex remodeling process that includes changes in the structure and content of key proteins, elastin and collagen. As these changes occur, the tissue mechanical properties also change. The natural history of AAA is progressive enlargement to a point of mechanical tissue failure typically followed by death. Currently, the marker used to predict the risk of impending rupture is the largest transverse diameter. After reaching a diameter threshold of 5.5 cm the aneurysm is surgically repaired. This criterion does not consider any patient-specific information or the known heterogeneity of the aneurysm that may, in some cases, lead to rupture before the aneurysm reaches the standard intervention threshold. Conversely, in many patients, continued observation beyond this threshold is safe.

Abdominal Aortic Aneurysm: From Clinical Imaging to Realistic Replicas

2013 ◽  
Vol 136 (1) ◽  
Author(s):  
Sergio Ruiz de Galarreta ◽  
Aitor Cazón ◽  
Raúl Antón ◽  
Ender A. Finol
Keyword(s):  
Wall Thickness ◽  
Physiological Stress ◽  
Ex Vivo ◽  
Casting Process ◽  
Aortic Aneurysms ◽  
Optical Methods ◽  
Patient Specific ◽  
Uniaxial Tensile ◽  
Element Analysis ◽  
Abdominal Aortic

The goal of this work is to develop a framework for manufacturing nonuniform wall thickness replicas of abdominal aortic aneurysms (AAAs). The methodology was based on the use of computed tomography (CT) images for virtual modeling, additive manufacturing for the initial physical replica, and a vacuum casting process and range of polyurethane resins for the final rubberlike phantom. The average wall thickness of the resulting AAA phantom was compared with the average thickness of the corresponding patient-specific virtual model, obtaining an average dimensional mismatch of 180 μm (11.14%). The material characterization of the artery was determined from uniaxial tensile tests as various combinations of polyurethane resins were chosen due to their similarity with ex vivo AAA mechanical behavior in the physiological stress configuration. The proposed methodology yields AAA phantoms with nonuniform wall thickness using a fast and low-cost process. These replicas may be used in benchtop experiments to validate deformations obtained with numerical simulations using finite element analysis, or to validate optical methods developed to image ex vivo arterial deformations during pressure-inflation testing.

Utilization of 3D MRI for the Evaluation of Sphincter Pharyngoplasty Insertion Site in Patients With Velopharyngeal Dysfunction

2021 ◽  
pp. 105566562110446
Author(s):  
Kazlin N. Mason ◽  
John E. Riski ◽  
Joseph K. Williams ◽  
Richard A. Jones ◽  
Jamie L. Perry
Keyword(s):  
Insertion Site ◽  
Patient Specific ◽  
3D Mri ◽  
Scar Contracture ◽  
Time Points ◽  
Repeated Measures Design ◽  
Initial Location ◽  
Tissue Changes ◽  
Sphincter Pharyngoplasty ◽  
Tissue Migration

Sphincter pharyngoplasty is a surgical method to treat velopharyngeal dysfunction. However, surgical failure is often noted and postoperative assessment frequently reveals low-set pharyngoplasties. Past studies have not quantified pharyngoplasty tissue changes that occur postoperatively and gaps remain related to the patient-specific variables that influence postoperative change. The purpose of this study was to utilize advanced three-dimensional imaging and volumetric magnetic resonance imaging (MRI) data to visualize and quantify pharyngoplasty insertion site and postsurgical tissue changes over time. A prospective, repeated measures design was used for the assessment of craniometric and velopharyngeal variables postsurgically. Imaging was completed across two postoperative time points. Tissue migration, pharyngoplasty dimensions, and predictors of change were analyzed across imaging time points. Significant differences were present between the initial location of pharyngoplasty tissue and the pharyngoplasty location 2 to 4 months postoperatively. The average postoperative inferior movement of pharyngoplasty tissue was 6.82 mm, although notable variability was present across participants. The pharyngoplasty volume decreased by 30%, on average. Inferior migration of the pharyngoplasty tissue was present in all patients. Gravity, scar contracture, and patient-specific variables likely interact, impacting final postoperative pharyngoplasty location. The use of advanced imaging modalities, such as 3D MRI, allows for the quantification and visualization of tissue change. There is a need for continued identification of patient-specific factors that may impact the amount of inferior tissue migration and scar contracture postoperatively.

Transport and Mixing in Patient Specific Abdominal Aortic Aneurysms With Lagrangian Coherent Structures

2012 ◽  
Author(s):  
Amirhossein Arzani ◽  
Shawn C. Shadden
Keyword(s):  
Coherent Structures ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Lagrangian Coherent Structures ◽  
Patient Specific ◽  
Complex Flow ◽  
Flow Topology ◽  
Finite Time Lyapunov Exponent ◽  
Abdominal Aortic ◽  
High Gradients

Abdominal aortic aneurysms (AAA) are characterized by disturbed flow patterns, low and oscillatory wall shear stress with high gradients, increased particle residence time, and mild turbulence. Diameter is the most common metric for rupture prediction, although this metric can be unreliable. We hypothesize that understanding the flow topology and mixing inside AAA could provide useful insight into mechanisms of aneurysm growth. AAA morphology has high variability, as with AAA hemodynamics, and therefore we consider patient-specific analyses over several small to medium sized AAAs. Vortical patterns dominate AAA hemodynamics and traditional analyses based on the Eulerian fields (e.g. velocity) fail to convey the complex flow structures. The computation of finite-time Lyapunov exponent (FTLE) fields and underlying Lagrangian coherent structures (LCS) help reveal a Lagrangian template for quantifying the flow [1].

Method for Incorporating Three-Dimensional Residual Stresses Into Patient-Specific Simulations of Arteries

2013 ◽  
Author(s):  
David M. Pierce ◽  
Thomas E. Fastl ◽  
Hannah Weisbecker ◽  
Gerhard A. Holzapfel ◽  
Borja Rodriguez-Vila ◽  
...  
Keyword(s):  
Medical Imaging ◽  
Three Dimensional ◽  
Constitutive Models ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Patient Specific ◽  
Abdominal Aortic ◽  
Model Geometry ◽  
Reconstructed Model

Through progress in medical imaging, image analysis and finite element (FE) meshing tools it is now possible to extract patient-specific geometries from medical images of, e.g., abdominal aortic aneurysms (AAAs), and thus to study clinically relevant problems via FE simulations. Medical imaging is most often performed in vivo, and hence the reconstructed model geometry in the problem of interest will represent the in vivo state, e.g., the AAA at physiological blood pressure. However, classical continuum mechanics and FE methods assume that constitutive models and the corresponding simulations start from an unloaded, stress-free reference condition.

scholarly journals A Methodology for the Derivation of Unloaded Abdominal Aortic Aneurysm Geometry With Experimental Validation

2016 ◽  
Vol 138 (10) ◽  
Author(s):  
Santanu Chandra ◽  
Vimalatharmaiyah Gnanaruban ◽  
Fabian Riveros ◽  
Jose F. Rodriguez ◽  
Ender A. Finol
Keyword(s):  
Finite Element ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stress Component ◽  
Wall Stress ◽  
Patient Specific ◽  
Element Analysis ◽  
Nodal Surface ◽  
Abdominal Aortic ◽  
Peak Wall Stress

In this work, we present a novel method for the derivation of the unloaded geometry of an abdominal aortic aneurysm (AAA) from a pressurized geometry in turn obtained by 3D reconstruction of computed tomography (CT) images. The approach was experimentally validated with an aneurysm phantom loaded with gauge pressures of 80, 120, and 140 mm Hg. The unloaded phantom geometries estimated from these pressurized states were compared to the actual unloaded phantom geometry, resulting in mean nodal surface distances of up to 3.9% of the maximum aneurysm diameter. An in-silico verification was also performed using a patient-specific AAA mesh, resulting in maximum nodal surface distances of 8 μm after running the algorithm for eight iterations. The methodology was then applied to 12 patient-specific AAA for which their corresponding unloaded geometries were generated in 5–8 iterations. The wall mechanics resulting from finite element analysis of the pressurized (CT image-based) and unloaded geometries were compared to quantify the relative importance of using an unloaded geometry for AAA biomechanics. The pressurized AAA models underestimate peak wall stress (quantified by the first principal stress component) on average by 15% compared to the unloaded AAA models. The validation and application of the method, readily compatible with any finite element solver, underscores the importance of generating the unloaded AAA volume mesh prior to using wall stress as a biomechanical marker for rupture risk assessment.

scholarly journals Identification of rupture locations in patient-specific abdominal aortic aneurysms using experimental and computational techniques

2010 ◽  
Vol 43 (7) ◽  
pp. 1408-1416 ◽  
Author(s):  
Barry J. Doyle ◽  
Aidan J. Cloonan ◽  
Michael T. Walsh ◽  
David A. Vorp ◽  
Timothy M. McGloughlin
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Patient Specific ◽  
Computational Techniques ◽  
Abdominal Aortic
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