Validated Computational Model to Compute Re-apposition Pressures for Treating Type-B Aortic Dissections
The use of endovascular treatment in the thoracic aorta has revolutionized the clinical approach for treating Stanford type B aortic dissection. The endograft procedure is a minimally invasive alternative to traditional surgery for the management of complicated type-B patients. The endograft is firs...
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doaj-0b26361a733642ac9dfa4a848257f7012020-11-24T21:57:47ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2018-05-01910.3389/fphys.2018.00513331399Validated Computational Model to Compute Re-apposition Pressures for Treating Type-B Aortic DissectionsAashish Ahuja0Xiaomei Guo1Jillian N. Noblet2Joshua F. Krieger3Blayne Roeder4Stephan Haulon5Sean Chambers6Ghassan S. Kassab7California Medical Innovations Institute, San Diego, CA, United StatesCalifornia Medical Innovations Institute, San Diego, CA, United StatesCook Medical, Bloomington, IN, United StatesCook Medical, Bloomington, IN, United StatesCook Medical, Bloomington, IN, United StatesAortic Center, Hôpital Marie Lannelongue, Université Paris Sud, Paris, FranceCook Medical, Bloomington, IN, United StatesCalifornia Medical Innovations Institute, San Diego, CA, United StatesThe use of endovascular treatment in the thoracic aorta has revolutionized the clinical approach for treating Stanford type B aortic dissection. The endograft procedure is a minimally invasive alternative to traditional surgery for the management of complicated type-B patients. The endograft is first deployed to exclude the proximal entry tear to redirect blood flow toward the true lumen and then a stent graft is used to push the intimal flap against the false lumen (FL) wall such that the aorta is reconstituted by sealing the FL. Although endovascular treatment has reduced the mortality rate in patients compared to those undergoing surgical repair, more than 30% of patients who were initially successfully treated require a new endovascular or surgical intervention in the aortic segments distal to the endograft. One reason for failure of the repair is persistent FL perfusion from distal entry tears. This creates a patent FL channel which can be associated with FL growth. Thus, it is necessary to develop stents that can promote full re-apposition of the flap leading to complete closure of the FL. In the current study, we determine the radial pressures required to re-appose the mid and distal ends of a dissected porcine thoracic aorta using a balloon catheter under static inflation pressure. The same analysis is simulated using finite element analysis (FEA) models by incorporating the hyperelastic properties of porcine aortic tissues. It is shown that the FEA models capture the change in the radial pressures required to re-appose the intimal flap as a function of pressure. The predictions from the simulation models match closely the results from the bench experiments. The use of validated computational models can support development of better stents by calculating the proper radial pressures required for complete re-apposition of the intimal flap.http://journal.frontiersin.org/article/10.3389/fphys.2018.00513/fullaortic dissectionbench testsporcine aortafinite element analysisre-apposition pressuresimulation models |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Aashish Ahuja Xiaomei Guo Jillian N. Noblet Joshua F. Krieger Blayne Roeder Stephan Haulon Sean Chambers Ghassan S. Kassab |
spellingShingle |
Aashish Ahuja Xiaomei Guo Jillian N. Noblet Joshua F. Krieger Blayne Roeder Stephan Haulon Sean Chambers Ghassan S. Kassab Validated Computational Model to Compute Re-apposition Pressures for Treating Type-B Aortic Dissections Frontiers in Physiology aortic dissection bench tests porcine aorta finite element analysis re-apposition pressure simulation models |
author_facet |
Aashish Ahuja Xiaomei Guo Jillian N. Noblet Joshua F. Krieger Blayne Roeder Stephan Haulon Sean Chambers Ghassan S. Kassab |
author_sort |
Aashish Ahuja |
title |
Validated Computational Model to Compute Re-apposition Pressures for Treating Type-B Aortic Dissections |
title_short |
Validated Computational Model to Compute Re-apposition Pressures for Treating Type-B Aortic Dissections |
title_full |
Validated Computational Model to Compute Re-apposition Pressures for Treating Type-B Aortic Dissections |
title_fullStr |
Validated Computational Model to Compute Re-apposition Pressures for Treating Type-B Aortic Dissections |
title_full_unstemmed |
Validated Computational Model to Compute Re-apposition Pressures for Treating Type-B Aortic Dissections |
title_sort |
validated computational model to compute re-apposition pressures for treating type-b aortic dissections |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Physiology |
issn |
1664-042X |
publishDate |
2018-05-01 |
description |
The use of endovascular treatment in the thoracic aorta has revolutionized the clinical approach for treating Stanford type B aortic dissection. The endograft procedure is a minimally invasive alternative to traditional surgery for the management of complicated type-B patients. The endograft is first deployed to exclude the proximal entry tear to redirect blood flow toward the true lumen and then a stent graft is used to push the intimal flap against the false lumen (FL) wall such that the aorta is reconstituted by sealing the FL. Although endovascular treatment has reduced the mortality rate in patients compared to those undergoing surgical repair, more than 30% of patients who were initially successfully treated require a new endovascular or surgical intervention in the aortic segments distal to the endograft. One reason for failure of the repair is persistent FL perfusion from distal entry tears. This creates a patent FL channel which can be associated with FL growth. Thus, it is necessary to develop stents that can promote full re-apposition of the flap leading to complete closure of the FL. In the current study, we determine the radial pressures required to re-appose the mid and distal ends of a dissected porcine thoracic aorta using a balloon catheter under static inflation pressure. The same analysis is simulated using finite element analysis (FEA) models by incorporating the hyperelastic properties of porcine aortic tissues. It is shown that the FEA models capture the change in the radial pressures required to re-appose the intimal flap as a function of pressure. The predictions from the simulation models match closely the results from the bench experiments. The use of validated computational models can support development of better stents by calculating the proper radial pressures required for complete re-apposition of the intimal flap. |
topic |
aortic dissection bench tests porcine aorta finite element analysis re-apposition pressure simulation models |
url |
http://journal.frontiersin.org/article/10.3389/fphys.2018.00513/full |
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