Intracranial stents being modeled as a porous medium: flow simulation in stented cerebral aneurysms

Intracranial aneurysms may be treated by flow diverters, alternatively to stents and coils combination. Numerical simulation allows the assessment of the complex nature of aneurismal flow. Endovascular devices present a rather dense and fine strut network, increasing the complexity of the meshing. We propose an alternative strategy, which is based on the modeling of the device as a porous medium. Two patient-specific aneurysm data sets were reconstructed using conventional clinical setups. The aneurysms selection was done so that intra-aneurismal flow was shear driven in one and inertia driven in the other. Stents and their porous medium analog were positioned at the aneurysm neck. Physiological flow and standard boundary conditions were applied. The comparison between both approaches was done by analyzing the velocity, vorticity, and shear rate magnitudes inside the aneurysm as well as the wall shear stress (WSS) at the aneurysm surface. Simulations without device were also computed. The average flow reduction reaches 76 and 41% for the shear and inertia driven flow models, respectively. When comparing the two approaches, results show a remarkable similarity in the flow patterns and magnitude. WSS, iso-velocity surfaces and velocity on a trans-sectional plane are in fairly good agreement. The root mean squared error on the investigated parameters reaches 20% for aneurysm velocity, 30.6% for aneurysm shear rate, and 47.4% for aneurysm vorticity. It reaches 20.6% for WSS computed on the aneurysm surface. The advantages of this approach reside in its facility to implement and in the gain in computational time. Results predicted by the porous medium approach compare well with the real stent geometry model and allow predicting the main effects of the device on intra-aneurismal flow, facilitating thus the analysis.     

Computational modeling of effects of mechanical shaking on hemodynamics in hollow fibers

Introduction: Blood-membrane interaction during hemodialysis develops a secondary protein layer on the dialysis membrane surface, resulting in reduction of hemodialyzer performance. Wall shear stress at the surface of the hollow-fiber membrane is one of the determinant factors able to influence dialysis efficiency. Shaking of hemodialyzer during treatment could increase the wall shear stress of the membrane, which could enhance hemodialyzer performance. Methods: In this study, hemodynamic changes in hollow fibers were analyzed using computational fluid dynamics software for various shaking conditions of hemodialyzer (longitudinal, transverse, rotational motions). Results: Longitudinal motion induced reverse flow, while transverse motion induced symmetric swirling inside the hollow fiber. During rotational motions, nonuniform vortices were developed according to the rotational radius of the hollow fiber. These changes in flow pathlines induced by different shaking profiles increased the relative motion of blood, transmembrane pressure, and wall shear stress on dialysis membrane surfaces. Both longitudinal and transverse shaking profiles showed a linear relationship between shaking velocity (the product of amplitude and frequency) and wall shear stress. Conclusion: Performance of hemodialyzer can be enhanced with simple mechanical shaking motions, and optimal shaking profiles for clinical application can be investigated and predicted with the computational fluid dynamics model proposed in this study.     

The state of cerebral hemodynamics in conditions of prolonged adaptation to hypercapnic hypoxia

Intermittent hypercapnic hypoxia was accompanied by increases in cerebral vascular resistance, decreases in the reactivity of cerebral vessels to hypercapnia, and increases in the collateral reserve and rate of autoregulation of brain blood flow. These changes were an important component of the mechanism increasing the tolerance of the brain to ischemia in response to training with hypercapnic hypoxia. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 94, No. 2, pp. 191–197, February, 2008.     

Finite-element modeling of the anthropoid mandible: the effects of altered boundary conditions

Finite-element modeling provides a full-field method for describing the stress environment of the skull. The utility of finite-element models, however, remains uncertain given our ignorance of whether such models validly portray states of stress and strain. For example, the effects of boundary conditions that are chosen to represent the mechanical environment in vivo are largely unknown. We conducted an in vitro strain gauge experiment on a fresh, fully dentate adult mandible of Macaca fascicularis to model a simplified loading regime by finite-element analysis for purposes of model validation. Under various conditions of material and structural complexity, we constructed dentate and edentulous models to measure the effects of changing boundary conditions (force orientation and nodal constraints) on strain values predicted at the gauge location. Our results offer a prospective assessment of the difficulties encountered when attempting to validate finite-element models from in vivo strain data. Small errors in the direction of load application produce significant changes in predicted strains. An isotropic model, although convenient, shows poor agreement with experimental strains, while a heterogeneous orthotropic model predicts strains that are more congruent with these data. Most significantly, we find that an edentulous model performs better than a dentate one in recreating the experimental strains. While this result is undoubtedly tied to our failure to model the periodontal ligament, we interpret the finding to mean that in the absence of occlusal loads, teeth within alveoli do not contribute significantly to the structural stiffness of the mandible.     

局部脑血栓形成对心脏血液动力学的影响

本文采用静注孟加拉红(lmg/100g体重)与滤过的氙灯光源(λ560nm,△λ60nm)反应诱导大鼠血栓性局部脑缺血,并以局部脑血流(regional cerebral blood flow,rCBF)、每搏输出量(stroke volume,SV)、心输出量(cardiac output,CO)、心率(heart rate,HR)及心、肝、脾、肾、肾上腺血流量(blood flow,BF)为指标,探讨光化学反应后不同时间脑血液动力学改变对心脏功能的影响。结果表明,光化学反应后rCBF明显减小(P<0.05);SV、CO亦明显降低(P<0.05);部份器官血液重新分布;但光化学反应后5天,梗塞区rCBF明显增加(P<0.01),SV、CO及心肌血流恢复至对照水平。初步证明脑梗塞与心功能改变之间具有明显的因果关系。     

利用非均匀格Boltzmann方法研究支架对颅内动脉瘤血流动力学的影响

目的研究截面为不同旋转角度的三角形支架对颅内动脉瘤血流动力学的影响。方法采用非均匀格子Boltzmann方法对支架区域进行局部加细,并结合曲边界处理格式对置入支架的颅内动脉瘤进行数值模拟。通过对动脉瘤内流动形态、瘤口速度、瘤内速度减小量等动力学参量的分析,探讨不同旋转角度支架用于治疗颅内动脉瘤的效果。结果在减小瘤内血流速度方面,旋转角为180°的三角形截面支架效果最好,无旋转的三角形截面支架引起的速度减少量最小。在孔隙率较低情况下,截面为不同旋转角度的三角形支架起到效果差异较小。结论非均匀格子Boltzmann方法结合曲边界处理格式可以较准确地研究动脉瘤血流动力学特性,为支架的设计提供参考依据,并为临床介入治疗法提供一定的指导。     

Computational study for the effects of coil configuration on blood flow characteristics in coil-embolized cerebral aneurysm

Coil embolization of cerebral aneurysms with inhomogeneous coil distribution leads to an incomplete occlusion of the aneurysm. However, the effects of this factor on the blood flow characteristics are still not fully understood. This study investigates the effects of coil configuration on the blood flow characteristics in a coil-embolized aneurysm using computational fluid dynamics (CFD) simulation. The blood flow analysis in the aneurysm with coil embolization was performed using a coil deployment (CD) model, in which the coil configuration was constructed using a physics-based simulation of the CD. In the CFD results, total flow momentum and kinetic energy in the aneurysm gradually decayed with increasing coil packing density (PD), regardless of the coil configuration attributed to deployment conditions. However, the total shear rate in the aneurysm was relatively high and the strength of the local shear flow varied based on the differences in coil configuration, even at adequate PDs used in clinical practice (20–25 %). Because the sufficient shear rate reduction is a well-known factor in the blood clot formation occluding the aneurysm inside, the present study gives useful insight into the effects of coil configuration on the treatment efficiency of coil embolization.     

Influence of different isoflurane anesthesia protocols on murine cerebral hemodynamics measured with pseudo‐continuous arterial spin labeling

Arterial spin labeling (ASL)‐MRI can noninvasively map cerebral blood flow (CBF) and cerebrovascular reactivity (CVR), potential biomarkers of cognitive impairment and dementia. Mouse models of disease are frequently used in translational MRI studies, which are commonly performed under anesthesia. Understanding the influence of the specific anesthesia protocol used on the measured parameters is important for accurate interpretation of hemodynamic studies with mice. Isoflurane is a frequently used anesthetic with vasodilative properties. Here, the influence of three distinct isoflurane protocols was studied with pseudo‐continuous ASL in two different mouse strains. The first protocol was a free‐breathing set‐up with medium concentrations, the second a free‐breathing set‐up with low induction and maintenance concentrations, and the third a set‐up with medium concentrations and mechanical ventilation. A protocol with the vasoconstrictive anesthetic medetomidine was used as a comparison. As expected, medium isoflurane anesthesia resulted in significantly higher CBF and lower CVR values than medetomidine (median whole‐brain CBF of 157.7 vs 84.4 mL/100 g/min and CVR of 0.54 vs 51.7% in C57BL/6 J mice). The other two isoflurane protocols lowered the CBF and increased the CVR values compared with medium isoflurane anesthesia, without obvious differences between them (median whole‐brain CBF of 138.9 vs 131.7 mL/100 g/min and CVR of 10.0 vs 9.6%, in C57BL/6 J mice). Furthermore, CVR was shown to be dependent on baseline CBF, regardless of the anesthesia protocol used.     

Computational analysis of the three-dimensional hemodynamics of the blood sac in the twin-pulse life-support system

Blood flow in the twin-pulse life-support system (T-PLS) pulsatile blood pump was simulated using a three-dimensional rigid body–fluid–solid interaction model. This model can delineate the blood flow in the T-PLS resulting from operation of a moving actuator. The numerical method used in this study was a commercial finite element package called ADINA. We used a contact and fluid–solid interaction model to compute the blood hemodynamics in the sac. Blood flow is generated by the motion of the actuator, which strongly interacts with the solid material surrounding the blood. To obtain basic bioengineering data on the optimum operation of the T-PLS, we simulated four models in which the actuator moved at different speeds and investigated both the flow pattern and the distribution of shear stress. During the contraction phase, a strong axial flow is observed around the outlet, whereas there is stagnant flow around the inlet. The maximum shear stress in each model depends on the operation mode; however, all four models have similar flow rates. The sinusoidal mode exhibited the lowest maximum shear stress and is thus considered the most efficient of the four operating modes.     

Experimental cerebral aneurysms in the female heterozygous Blotchy mouse

The Blotchy mouse is characterized by an X-linked inherited disorder of connective tissue synthesis. The susceptibility to aneurysm formation in the cerebral arteries of the circle of Willis was compared in female heterozygous 'Blotchy' and control mice subjected to unilateral carotid artery ligation either alone or associated with hypertension. Cerebral aneurysms developed only in hypertensive Blotchy mice (6/31 vs. 0/30 in hypertensive controls). Aneurysms of the aorta and its major branches occurred in normotensive mice only in the Blotchy group in which hypertension increased the incidence of mesenteric and coeliac aneurysms. A light microscopic study of interruptions of the internal elastic lamina (IIEL) showed that they developed in arteries of both Blotchy and control mice but to a greater extent in the Blotchy group where hypertension further increased their incidence. The IIEL incidence in the aortic arch varied in parallel to the occurrence of aneurysms in all the different arterial sites. Thus, in an apparently normally viable animal, the presence of a mutated gene which indirectly leads to defective elastin and collagen fibre synthesis, favours the formation of both peripheral and cerebral aneurysms. However, the development of cerebral aneurysms requires the addition of an increase in haemodynamic stress.     

Analysis of the effects of measured white blood cell entrance times on hemodynamics in a computer model of a microvascular bed

To quantify the interdependence of capillary leukocyte plugging and microvascular hemodynamics, experimental measurements were made of the time required for lymphocytes and granulocytes to enter a micropipette. Using standard micropipette deformation techniques, entrance times were found to be a function of both cell diameter and pipette diameter, with no significant dependence on aspiration pressure over the differential pressure range of 200–400 Pa. Experimental results were combined with a computer network model to describe changes in red cell distribution and flow rate resulting from the delayed entrance of leukocytes (WBC) into capillaries. The network model is based on geometrical measurements from the capillary bed of a hamster cremaster muscle (Sarelius et al. 1981) and utilizes previous work describing: 1. preferential cell distribution at a bifurcation, 2. increased apparent viscosity due to the presence of red and white cells, and 3. increased velocities of red and white cells relative to blood. Red and white cell positions within the network were computed at discrete time increments, and WBC plugging was simulated by a temporary cessation of flow in vessels of smaller diameter than the white cell. In contrast with previous studies, the increased viscosity due to the presence of WBCs was found to have an insignificant effect on overall network flow rate. Instead, a major flow reduction occurs only when capillaries are plugged by the white cells. At normal physiological concentrations (1,000 RBC/WBC), time-averaged overall network flow is reduced by 4.4%, based on averaged experimentally measured entrance times, and up to 14.8% if maximal entrance times are used. Overall flow rates fluctuate significantly with time and, at concentrations greater than 1 WBC/200 RBC, decrease substantially with increasing WBC concentration. At levels comparable to acute leukemia (70 RBC/WBC), flow is severely compromised due to numerous WBC occlusions. In the absence of WBCs, mean hematocrit and hematocrit distribution compare well with published values. Spatial variations in hematocrit are notable, however, and capillaries originating from the upstream end of the arteriole have a much lower hematocrit than downstream branches (by a factor of two, on average) due to preferential distribution of red blood cells.Support for this research was obtained under NIH Grants HL-23355 and HL-18208; this paper is partially based on work performed under contract No. DE-AC02-76EV03490 with the U.S. Department of Energy at the University of Rochester Department of Radiation Biology and Biophysics and has been assigned report No. DOE/EV/03490-2415     

Altering end-to-side anastomosis junction hemodynamics: the effects of flow-splitting

The long-term patency rate of peripheral artery bypass grafts remains low. Several theories exist which attempt to explain the disease forming mechanisms at the disease prone distal junction of the bypass graft. Common to these theories is that abnormal hemodynamics and wall mechanics contribute to the development of disease at the junction. This study describes a means by which the hemodynamics in the end-to-side anastomosis can be altered by inserting a flow-split into the junction, the function of which is to divert the flow away from the artery bed and toward the sidewalls. Velocity vectors through the junction are significantly altered, and artery centreline WSS magnitudes decrease by up to 36% during the deceleration phase of the flow pulse. Corresponding wall shear stress gradients are found to decrease by 49%. However, locations along the artery sidewall have been identified with increased WSS. It is possible to significantly alter junction hemodynamics using a flow-splitter.     

Rheoencephalographic study of the cerebral hemodynamics during mental work

Rheoencephalographic investigation of healthy persons engaged in mental work revealed an increase in the volume blood flow through the left hemisphere on account of an increase in the period of filling of the vessels; the incoming blood volume was increased in the temporal region. By the end of the working day these changes were replaced by a disturbance of regulation of the volume blood flow in the temporal regions.Presented by Academician V. V. Parin.Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 70, No. 12, pp. 9–11, December, 1970.     

Effects of end boundary conditions and specimen geometry on the viscoelastic properties of cancellous bone measured by dynamic mechanical analysis

The viscoelastic properties of cancellous bone can be measured nondestructively in compression testing using a dynamic mechanical analyzer. In this study, we examined the effects of end boundary conditions and specimen geometry on the viscoelastic properties of cancellous bone measured by dynamic mechanical analysis. During dynamic compression testing, the cancellous bone specimens may be mechanically fixed (e.g., glued) to the loading platens or they may be free to expand across the platen surface. When specimens of cancellous bone were tested between platens with gluing, the dependence of loss tangent on frequency was not consistent with previously observed strain-rate-dependent mechanical behavior of cancellous bone. When long specimens of cancellous bone (length = 10 mm, diameter = 8 mm) were tested without gluing, the relationship between loss tangent and frequency depended on the level of load applied. For short specimens (length = 5 mm, diameter = 8 mm) tested without gluing, however, the frequency dependence of loss tangent agreed with existing data reported for the strain-rate-dependent behavior of cancellous bone and also with the frequency dependence of cortical bone viscoelasticity. Therefore, we recommend that short cancellous bone cylinders with a length of 5 mm and a diameter of 8 mm should be used without gluing in the dynamic mechanical analysis of cancellous bone. This is consistent with the American Society for Testing and Materials testing recommendations for plastics, but different from current practice for unimodal mechanical testing of cancellous bone.     

Personality/behavioral characteristics in children: differential effects of putative anterior versus posterior cerebral asymmetry.

The current study was carried out to examine the possible relationships among personality/behavioral characteristics and anterior/posterior (A/P) functional cerebral asymmetry in children referred for learning problems. Two hundred nineteen children between 7 and 12 years of age were administered a battery of neuropsychological measures, and their parents completed the Child Behavior Checklist (CBC) and the Personality Inventory for Children-Revised (PIC). Anterior and posterior composite scores were obtained for each subject using scores on the neuropsychological measures. Out of this subject pool, 33 children had sufficient anterior/posterior (A/P) score differences (i.e., greater than one standard deviation difference) to permit their categorization into either an A (n = 19) or P (n = 14) group. The MANOVA results showed that the A group scored significantly higher than the P group on the CBC scales of social withdrawal, aggressiveness, hyperactivity and externalizing, while the P group scored higher, though not significantly, on the (PIC) scale of anxiety. Thus, it appeared that, by using neuropsychological measures along the A/P dimension to classify children with learning problems, significant differences could also be identified on personality/ behavioral variables for some children. In addition, in the current study, children with A type functional cerebral asymmetry exhibited a relatively greater number of behavioral problems.     

Flow analyses in the lower airways: patient-specific model and boundary conditions

Computational fluid dynamics (CFD) is increasingly applied in the respiratory domain. The ability to simulate the flow through a bifurcating tubular system has increased the insight into the internal flow dynamics and the particular characteristics of respiratory flows such as secondary motions and inertial effects. The next step in the evolution is to apply the technique to patient-specific cases, in order to provide more information about pathological airways. This study presents a patient-specific approach where both the geometry and the boundary conditions (BC) are based on individual imaging methods using computed tomography (CT). The internal flow distribution of a 73-year-old female suffering from chronic obstructive pulmonary disease (COPD) is assessed. The validation is performed through the comparison of lung ventilation with gamma scintigraphy. The results show that in order to obtain agreement within the accuracy limits of the gamma scintigraphy scan, both the patient-specific geometry and the BC (driving pressure) play a crucial role. A minimal invasive test (CT scan) supplied enough information to perform an accurate CFD analysis. In the end it was possible to capture the pathological features of the respiratory system using the imaging and computational fluid dynamics techniques. This brings the introduction of this new technique in the clinical practice one step closer.     

Computational predictions of pulmonary blood flow gradients: gravity versus structure

A computational model of blood flow through the human pulmonary arterial tree has been developed to investigate the mechanisms contributing to regional pulmonary perfusion in the isolated network when the lung is in different orientations. The arterial geometric model was constructed using a combination of computed tomography and a volume-filling branching algorithm. Equations governing conservation of mass, momentum, and vessel distension, incorporating gravity, were solved to predict pressure, flow, and vessel radius. Analysis of results in the upright posture, with and without gravity, and in the inverted, prone, and supine postures reveals significant flow heterogeneity and a persistent decrease in flow in the cranial and caudal regions for all postures suggesting that vascular geometry makes a major contribution to regional flow with gravity having a lesser role. Results in the isolated arterial tree demonstrate that the vascular path lengths and therefore the positioning of the pulmonary trunk relative to the rest of the network play a significant role in the determination of flow.