scholarly journals Distribution of Artificial Thrombi Candidates Through Patient-Specific Aortic-Arch Phantoms under Pulsatile Flow Conditions

Author(s):  
Marco Testaguzza ◽  
Mehdi Benhassine ◽  
Haroun Frid ◽  
Laurence Gebhart ◽  
Karim Zouaoui Boudjeltia ◽  
...  

Abstract Ischemic Stroke is the most frequent type of stroke and is subject to many studies investigating prevention means. Avoiding the difficulties and ethical problems of experimental in-vivo research, in-vitro testing is a convenient way of studying in controlled conditions the morphological impact and mechanical aspects of emboli dynamics. This in-vitro study was performed with two realistic silicone aortic-arch phantoms submitted to physiological pulsatile flow conditions. In the in-vitro test bed, using automatic image tracking and analysis, it was made possible detecting and tracking artificial spherical emboli candidates circulating in the anatomic aortic-arch models under a realistic based-patient blood flow profile. The emboli trajectories as well as their repartition in the different supra-aortic branches are presented for the two aortic-arch geometries obtained from CT scans. Through a statistical analysis performed with several artificial emboli sizes, the experimental study shows that the repartition percentages of the emboli closely follow the flowrate repartition percentages for both aortic-arch models, suggesting that higher flowrates lead to higher concentrations of emboli in a given artery. Sets of human thrombi were also injected and the repartition percentages have been established, giving the same trend as for artificial emboli.

2019 ◽  
Vol 141 (10) ◽  
Author(s):  
F. Malone ◽  
E. McCarthy ◽  
P. Delassus ◽  
J. H. Buhk ◽  
J. Fiehler ◽  
...  

Atrial fibrillation (AF) is the most common irregular heartbeat among the world's population and is a major contributor to cardiogenic embolisms and acute ischemic stroke (AIS). However, the role AF flow plays in the trajectory paths of cardiogenic emboli has not been experimentally investigated. A physiological simulation system was designed to analyze the trajectory patterns of bovine embolus analogs (EAs) (n = 720) through four patient-specific models, under three flow conditions: steady flow, normal pulsatile flow, and AF pulsatile flow. It was seen that EA trajectory paths were proportional to the percentage flowrate split of 25–31% along the branching vessels. Overall, AF flow conditions increased trajectories through the left- (LCCA) and right (RCCA)-common carotid artery by 25% with respect to normal pulsatile flow. There was no statistical difference in the distribution of clot trajectories when the clot was released from the right, left, or anterior positions. Significantly, more EAs traveled through the brachiocephalic trunk (BCT) than through the LCCA or the left subclavian. Yet of the EAs that traveled through the common carotid arteries, there was a greater affiliation toward the LCCA compared to the RCCA (p < 0.05).


Author(s):  
Antonio Gallarello ◽  
Andrea Palombi ◽  
Giacomo Annio ◽  
Shervanthi Homer-Vanniasinkam ◽  
Elena De Momi ◽  
...  

Abstract Validation of computational models using in vitro phantoms is a nontrivial task, especially in the replication of the mechanical properties of the vessel walls, which varies with age and pathophysiological state. In this paper, we present a novel aortic phantom reconstructed from patient-specific data with variable wall compliance that can be tuned without recreating the phantom. The three-dimensional (3D) geometry of an aortic arch was retrieved from a computed tomography angiography scan. A rubber-like silicone phantom was manufactured and connected to a compliance chamber in order to tune its compliance. A lumped resistance was also coupled with the system. The compliance of the aortic arch model was validated using the Young's modulus and characterized further with respect to clinically relevant indicators. The silicone model demonstrates that compliance can be finely tuned with this system under pulsatile flow conditions. The phantom replicated values of compliance in the physiological range. Both, the pressure curves and the asymmetrical behavior of the expansion, are in agreement with the literature. This novel design approach allows obtaining for the first time a phantom with tunable compliance. Vascular phantoms designed and developed with the methodology proposed in this paper have high potential to be used in diverse conditions. Applications include training of physicians, pre-operative trials for complex interventions, testing of medical devices for cardiovascular diseases (CVDs), and comparative Magnetic-resonance-imaging (MRI)-based computational studies.


2014 ◽  
Vol 36 (10) ◽  
pp. 1233-1245 ◽  
Author(s):  
Foad Kabinejadian ◽  
Dhanjoo N. Ghista ◽  
Boyang Su ◽  
Mercedeh Kaabi Nezhadian ◽  
Leok Poh Chua ◽  
...  

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Fanette Chassagne ◽  
Sujatha Buddhe ◽  
Lester C Permut ◽  
David MCMULLAN ◽  
Stephen P Seslar ◽  
...  

Introduction: Coarctation of the aorta is a congenital malformation of the proximal descending aorta that results in severe narrowing of the vessel lumen. It causes significant changes in the aortic hemodynamics, including reduced blood flow and an increased pressure gradient in this area of the vasculature. When this congenital cardiac malformation is associated with aortic arch hypoplasia, a two step-surgery is proposed: first, an end-to-end anastomosis in performed to remove all the ductal tissue surrounding the coarctation, and then the aorta is longitudinally incised and patched to increase its diameter. The design of the patch, based on the surgeon’s experience, is done in the OR. A combined in silico and in vitro approach is proposed to test the possibility of a priori design of the patch. This approach would also open the door to optimization of the patch to restore physiological hemodynamics in the aorta. Methods & Results: CFD simulations of the hemodynamics in the pre-treatment aortic arch were created from the segmentation of patients’ images who received surgical treatment at Seattle Children’s Hospital. In vivo hemodynamics data were used as boundary conditions for the simulation. The design of the patch was created via an in-house code and was based on surgeons’ input: the locations of the start and the end of the lumen enlargement and the length of the aortic segment to be resected. The optimization of the patch design was performed by comparing the simulated hemodynamics (pressure drop, endothelial shear stress, size of the recirculation region, ...) before and after the patch repair. The optimized patch design was then used by the surgeon to perform the in vitro surgical treatment on a physical model of the patient’s anatomy, made in a translucent silicon rubber. The repaired anatomical model was scanned by X-ray microtomography and cast in an optically clear silicone. Time-resolved particle image velocimetry measurements were performed to characterize the post-treatment hemodynamics, and compared to the results of the CFD simulation. Conclusions: This unique in silico and in vitro approach allows surgeons to perform different repairs on patient-specific physical in vitro models and to optimize the design of the patch prior to starting the surgery.


2019 ◽  
Vol 3 (s1) ◽  
pp. 25-25
Author(s):  
Elisia Clark ◽  
Laura Struzyna ◽  
Wisberty Gordián-Vélez ◽  
Kacy Cullen

OBJECTIVES/SPECIFIC AIMS: Selective loss of long-projecting neural circuitry is a common feature of many neurodegenerative diseases, such as the vulnerable nigrostriatal pathway in Parkinson’s disease (PD). Current in vitro approaches for studying disease development generally do not mimic complex anatomical features of the afflicted substrates such as long axonal pathways between stereotypical neural populations. Such exquisite features are not only crucial for neural systems function but may also contribute to the preferential vulnerability and pathophysiological progression of these structures in neurodegenerative disease. We have previously developed micro-tissue engineered neural networks to recapitulate the anatomy of long-projecting cortical axonal tracts encased in a tubular hydrogel.1 Recently, we have extended this work to include the first tissue-engineered nigrostriatal pathway that was anatomically-inspired to replicate the structure and function of the native pathway.2 Notably, this tissue-engineered brain pathway possesses three-dimensional (3D) structure, multicellular composition, and architecture of long axonal tracts between distinct neuronal populations. Therefore, in the current study we apply this system as a biofidelic test-bed for evaluating axonal pathway development, maturation, and pathophysiology. METHODS/STUDY POPULATION: Dopaminergic neurons from the ventral mesencephalon and medium spiny neurons (MSNs) from the striatum were separately isolated from rat embryos. Tissue-engineered nigrostriatal pathways were formed by initially seeding dopaminergic neuron aggregates at one end of hollow hydrogel micro-columns with a central extracellular matrix, collectively spanning up to several centimeters in length. Several days later, tissue-engineered MSN aggregate was seeded on the other end and was allowed to integrate. Immunocytochemistry (ICC) and confocal microscopy were used to assess health, cytoarchitecture, synaptic integration, and mitochondrial dynamics with stains that label cell nuclei (Hoechst) and mitochondria (MitoTracker Red) and antibodies that recognize axons (anti-β-tubulinIII), neurons/dendrites (anti-MAP2), dopaminergic neurons/axons (anti-tyrosine hydroxylase; TH), and MSNs (anti-DARPP-32). RESULTS/ANTICIPATED RESULTS: Seeding tubular micro-columns with dopaminergic neuronal aggregates resulted in unidirectional axonal extension, ultimately spanning >5mm by 14 days in vitro. For constructs also seeded with Tissue-engineered, ICC confirmed the presence of the appropriate neuronal sub-types in the two aggregate populations, specifically TH+ dopaminergic neurons and DARPP-32+ MSNs. Moreover, confocal microscopy revealed extensive axonal-dendritic integration and synapse formation involving the dopaminergic axons and MSN somata/dendrites. Collectively, these constructs mimicked the general cytoarchitecture of the in vivo nigrostriatal pathway: a discrete population of dopaminergic neurons with long-projecting 3D axonal tracts that were synaptically integrated with a population of MSNs. Mitochondria structure along axonal tracts was also observed using MitoTracker staining, revealing dynamic intra-axonal mitochondrial motility in this system. Ongoing studies are evaluating real-time mitochondrial dynamics and axonal physiology in this tissue-engineered nigrostriatal pathway in vitro, under both baseline conditions as well as following the addition of exogenous α-Synuclein fibrils to model synucleinopathy in PD. DISCUSSION/SIGNIFICANCE OF IMPACT: This tissue-engineered nigrostriatal pathway provides an anatomically-inspired platform with neuronal-axonal architecture that structurally and functionally emulates the nigrostriatal pathway in vivo. We are applying this paradigm as a powerful in vitro test-bed for understanding mitochondrial activity and inter-axonal energetics pathways under homeostatic as well as PD pathological conditions. Successful demonstration will serve as proof-of-concept that this technique can be used to study mitochondria pathology in personalized constructs built using cells derived from PD patients in order to evaluate pharmacological therapies targeted at improving mitochondrial resiliency and fitness so as to delay and/or prevent dopaminergic axonal/neuronal degeneration in tailored to specific PD patients.


Author(s):  
Fiona Malone ◽  
Eugene McCarthy ◽  
Patrick Delassus ◽  
Jan-Hendrick Buhk ◽  
Jens Fiehler ◽  
...  

Atrial fibrillation is the most significant contributor to thrombus formation within the heart and is responsible for 45% of all cardio embolic strokes, which account for approximately 15% of acute ischemic strokes cases worldwide. Atrial fibrillation can result in a reduction of normal cardiac output and cycle length of up to 30% and 40%, respectively. A total of 240 embolus analogues were released into a thin-walled, patient-specific aortic arch under normal (60 embolus analogues) and varying atrial fibrillation (180 embolus analogues) pulsatile flow conditions. Under healthy flow conditions (n = 60), the embolus analogues tended to follow the flow rate split through each outlet vessel. There was an increase in clot trajectories along the common carotid arteries under atrial fibrillation flow conditions. A shorter pulse period (0.3 s) displayed the highest percentage of clots travelling to the brain (24%), with a greater percentage of clots travelling through the left common carotid artery (17%). This study provides an experimental insight into the effect varying cardiac output and cycle length can have on the trajectory of a cardiac source blood clots travelling to the cerebral vasculature and possibly causing a stroke.


Author(s):  
Fuxing Zhang ◽  
Craig Lanning ◽  
Luciano Mazzaro ◽  
Bryan Rech ◽  
S. James Chen ◽  
...  

Echo Particle Image Velocimetry (Echo PIV), a novel opaque flow velocimetry technique developed in our laboratory, has been shown to be an effective 2-D flow measurement velocimetry method in prior studies for both steady and pulsatile flow conditions [1,2]. However, certain limitations remained in the first-generation system. These include inconsistent spatial resolution caused by the phased array transducer, and the relatively low frame rate (i.e., lower temporal resolution) [2]. To overcome these limitations, we developed a second-generation Echo PIV system with a custom-designed linear array transducer (5–14MHz, center frequency 10MHz) and customized post-processing of backscatter data. In vascular applications, the new system can provide frame rates up to 1428 fps (temporal resolution of 0.7 ms). The transducer has a consistent axial resolution of 150um, which brings a maximal velocity field resolution around 500um in axial direction. An ECG module was also integrated to enable the capture of ensemble data over the cardiac cycle.


2021 ◽  
Vol 8 (2) ◽  
pp. e147
Author(s):  
Steven Arcidiacono ◽  
Amy M. Ehrenworth Breedon ◽  
Michael S. Goodson ◽  
Laurel A. Doherty ◽  
Wanda Lyon ◽  
...  

In vitro fermentation systems offer significant opportunity for deconvoluting complex metabolic dynamics within polymicrobial communities, particularly those associated with the human gut microbiome. In vitro gut models have broad experimental capacity allowing rapid evaluation of multiple parameters, generating knowledge to inform design of subsequent in vivo studies. Here, our method describes an in vitro fermentation test bed to provide a physiologically-relevant assessment of engineered probiotics circuit design functions. Typically, engineered probiotics are evaluated under pristine, monoor co-culture conditions and transitioned directly into animal or human studies, commonly resulting in a loss of desired function when introduced to complex gut communities. Our method encompasses a systematic workflow entailing fermentation, molecular and functional characterization, and statistical analyses to validate an engineered probiotic’s persistence, plasmid stability and reporter response. To demonstrate the workflow, simplified polymicrobial communities of human gut microbial commensals were utilized to investigate the probiotic Escherichia coli Nissle 1917 engineered to produce a fluorescent reporter protein. Commensals were assembled with increasing complexity to produce a mock community based on nutrient utilization. The method assesses engineered probiotic persistence in a competitive growth environment, reporter production and function, effect of engineering on organism growth and influence on commensal composition. The in vitro test bed represents a new element within the Design-Build-Test-Learn paradigm, providing physiologically-relevant feedback for circuit re-design and experimental validation for transition of engineered probiotics to higher fidelity animal or human studies.  


2019 ◽  
Vol 48 (1) ◽  
pp. 18-24
Author(s):  
Anna Lorenzin ◽  
Mauro Neri ◽  
Massimo de Cal ◽  
Giordano Pajarin ◽  
Giuseppe Mansi Montenegro ◽  
...  

Background: Recent innovations in biomaterials technology have led to the development of innovative sorbents adopted as adsorbing devices in the field of extracorporeal blood purification therapies. As removal mechanism, adsorption allows to remove specific molecules, selectively binding them to sorbent materials. In addition to the material properties, a quintessential aspect influencing device properties is blood flow distribution within the sorbent particles. Objectives: In order to adequately characterize the potential adsorbing properties for an effective blood purification therapy, an in vitro study assessing the fluid dynamics inside 3 new cartridges, HA130, HA230 and HA330 (Jafron, Zhuhai City, ­China) was conducted through CT imaging technique. ­Methods: The cartridges were placed in vertical position in the CT ­gantry. Dye solution was circulated through the cartridges at 250 mL/min, longitudinal sections, 0.5 cm thick, were recorded for 60 s. Furthermore, an in vitro test was conducted to build pressure drop profiles. Blood was circulated at a different flow rate, 100–400 mL/min, step 50 mL/min. Pre and post cartridges pressures were acquired and pressure drop calculated. Results: Sequential images demonstrated an excellent distribution of the flow inside the cartridges. Average flow velocity was 0.37 cm/s for the 3 cartridges. HA130 had a homogeneous flow profile along the entire length of the device; HA230 and HA330 showed minimal differences between central and peripheral regions. Pressure drop profiles resulted linear, increasing proportionally with blood flow rate and packing density. Conclusions: We may conclude that the structural and functional design of the studied cartridges is adequate for haemoperfusion with no channelling phenomena. This ensures maximum and optimal utilization of the sorbent contained in the devices.


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