In Silico Modelling of Aortic Strain and Strain Rate in Aortic Coarctation Treated with Stent Angioplasty with Comparison to Clinical Cohorts
ABSTRACT: Objective: Treatment of aortic coarctation has seen a shift from traditional surgical repair to the use of aortic stents. The aim of this study was to assess the impact upon hemodynamics and arterial strain when aortic coarctation is treated with a stent using an experimental coarctation...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Applications in Engineering Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666496822000395 |
| _version_ | 1811178848322060288 |
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| author | Nicholas Gaddum Des Dillon-Murphy Richard Arm Isma Rafiq Radomir Chabiniok Gareth Morgan Tobias Schaeffter Tarique Hussain |
| author_facet | Nicholas Gaddum Des Dillon-Murphy Richard Arm Isma Rafiq Radomir Chabiniok Gareth Morgan Tobias Schaeffter Tarique Hussain |
| author_sort | Nicholas Gaddum |
| collection | DOAJ |
| description | ABSTRACT: Objective: Treatment of aortic coarctation has seen a shift from traditional surgical repair to the use of aortic stents. The aim of this study was to assess the impact upon hemodynamics and arterial strain when aortic coarctation is treated with a stent using an experimental coarctation model, and to confirm any findings in a clinical cohort using MRI. Methods: An experimental patient model included a silicone arterial tree, and ventricular stroke profile was derived from patient MRI data. Pressure, flow and aortic strain was measured before and after stent placement in the model. A clinical study comprised of strain measurements using MRI in two patient cohorts; those treated with a stent, and those treated with surgical repair. Results: Before stent placement, peak strain decreased as the pulse propagated away from the aortic valve. After stent placement however, peak strain was amplified as it approached the stent, despite peak systolic pressure having dropped by 20 mmHg. Introduction of the stent caused an almost three fold increase in aortic strain rate to 150%.s − 1. Echoing these results the stented patient group's strain increased from 28% +/- 14% in the ascending aorta to 43% +/- 24% (p < 0.05) pre-coarctation. This was not seen in those with surgical repair of coarctation, (ascending aorta 40% +/- 22% compared to the pre-coarctation aorta strain 38% +/- 20%, p = 0.81). Conclusions: Despite a reduced systolic pressure gradient through a stented coarctation, dramatic increases in strain and strain rate could attribute subsequent pathologies in the aorta proximally. |
| first_indexed | 2024-04-11T06:25:57Z |
| format | Article |
| id | doaj.art-15daba03c50043d890d161b6b40baa5b |
| institution | Directory Open Access Journal |
| issn | 2666-4968 |
| language | English |
| last_indexed | 2024-04-11T06:25:57Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Applications in Engineering Science |
| spelling | doaj.art-15daba03c50043d890d161b6b40baa5b2022-12-22T04:40:23ZengElsevierApplications in Engineering Science2666-49682022-12-0112100123In Silico Modelling of Aortic Strain and Strain Rate in Aortic Coarctation Treated with Stent Angioplasty with Comparison to Clinical CohortsNicholas Gaddum0Des Dillon-Murphy1Richard Arm2Isma Rafiq3Radomir Chabiniok4Gareth Morgan5Tobias Schaeffter6Tarique Hussain7King's College London, Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United KingdomKing's College London, Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United KingdomNottingham Trent University, College of Art & Design and Built Environment, School of Art & Design, Nottingham, United KingdomKing's College London, Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United KingdomKing's College London, Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United Kingdom; UT Southwestern Medical Centre, Department of Pediatrics, Dallas, TX, United States of AmericaEvelina Children's Hospital, St Thomas’ Hospital, Westminster Bridge Road, London, United KingdomKing's College London, Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United Kingdom; Physikalisch-Technische Bundesanstalt (PTB), Medical Physics and Metrological Information Technology Berlin, GermanyKing's College London, Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United Kingdom; UT Southwestern Medical Centre, Department of Pediatrics, Dallas, TX, United States of America; Corresponding authorABSTRACT: Objective: Treatment of aortic coarctation has seen a shift from traditional surgical repair to the use of aortic stents. The aim of this study was to assess the impact upon hemodynamics and arterial strain when aortic coarctation is treated with a stent using an experimental coarctation model, and to confirm any findings in a clinical cohort using MRI. Methods: An experimental patient model included a silicone arterial tree, and ventricular stroke profile was derived from patient MRI data. Pressure, flow and aortic strain was measured before and after stent placement in the model. A clinical study comprised of strain measurements using MRI in two patient cohorts; those treated with a stent, and those treated with surgical repair. Results: Before stent placement, peak strain decreased as the pulse propagated away from the aortic valve. After stent placement however, peak strain was amplified as it approached the stent, despite peak systolic pressure having dropped by 20 mmHg. Introduction of the stent caused an almost three fold increase in aortic strain rate to 150%.s − 1. Echoing these results the stented patient group's strain increased from 28% +/- 14% in the ascending aorta to 43% +/- 24% (p < 0.05) pre-coarctation. This was not seen in those with surgical repair of coarctation, (ascending aorta 40% +/- 22% compared to the pre-coarctation aorta strain 38% +/- 20%, p = 0.81). Conclusions: Despite a reduced systolic pressure gradient through a stented coarctation, dramatic increases in strain and strain rate could attribute subsequent pathologies in the aorta proximally.http://www.sciencedirect.com/science/article/pii/S2666496822000395CoarctationStent angioplastyExperimental modelArterial modelingPressureArterial strain |
| spellingShingle | Nicholas Gaddum Des Dillon-Murphy Richard Arm Isma Rafiq Radomir Chabiniok Gareth Morgan Tobias Schaeffter Tarique Hussain In Silico Modelling of Aortic Strain and Strain Rate in Aortic Coarctation Treated with Stent Angioplasty with Comparison to Clinical Cohorts Applications in Engineering Science Coarctation Stent angioplasty Experimental model Arterial modeling Pressure Arterial strain |
| title | In Silico Modelling of Aortic Strain and Strain Rate in Aortic Coarctation Treated with Stent Angioplasty with Comparison to Clinical Cohorts |
| title_full | In Silico Modelling of Aortic Strain and Strain Rate in Aortic Coarctation Treated with Stent Angioplasty with Comparison to Clinical Cohorts |
| title_fullStr | In Silico Modelling of Aortic Strain and Strain Rate in Aortic Coarctation Treated with Stent Angioplasty with Comparison to Clinical Cohorts |
| title_full_unstemmed | In Silico Modelling of Aortic Strain and Strain Rate in Aortic Coarctation Treated with Stent Angioplasty with Comparison to Clinical Cohorts |
| title_short | In Silico Modelling of Aortic Strain and Strain Rate in Aortic Coarctation Treated with Stent Angioplasty with Comparison to Clinical Cohorts |
| title_sort | in silico modelling of aortic strain and strain rate in aortic coarctation treated with stent angioplasty with comparison to clinical cohorts |
| topic | Coarctation Stent angioplasty Experimental model Arterial modeling Pressure Arterial strain |
| url | http://www.sciencedirect.com/science/article/pii/S2666496822000395 |
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