| 1. |
- Hyhlik-Dürr, A., et al.
(författare)
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Finite Element Analysis of Abdominal Aortic Aneurysms : Preliminary Results of Intra and Inter observer Validation
- 2010
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Konferensbidrag (refereegranskat)abstract
- Objective: Treatment of abdominal aortic aneurysm (AAA) is indicated if risk for rupture exceeds the risk for aortic repair. Estimation of the individual risk for rupture in AAA is therefore essential. The diameter of AAA is known as an independent risk factor for rupture and therefore the base of indication for surgical or endovascular therapy. For more sensitive patient selection, other morphological or hemodynamic predictors such as volume or peak wall stress have to be evaluated. The purpose of this study was to analyze the reproducibility of diameter measurement, volume estimation and peak wall stress calculation in AAA by finite element analysis. Methods: Computed tomography angiography (CTA) scans of 10 patients with AAA and 4 volunteers with healthy infrarenal aortas were analyzed by three independent investigators. A semiautomatic reconstruction using two- and three-dimensional deformable (active) contour models was used to segment vascular bodies from CTA data. Centreline calculated maximal diameter and volume measurements, as extracted from the reconstructed abdominal aorta, as well as peak wall stress, as predicted by three-dimensional non-linear finite element models, were analyzed. Specifically, aortic wall and thrombus tissue were captured by isotropic, non-linear and finite strain constitutive models. Likewise, mean arterial pressure was applied at the luminal surface, the vessels were fixed at the renal arteries and the aortic bifurcation and no contact with surrounding organs was considered. Inter- and intra-observer variabilities for diameter, volume and peak wall stress measurements were assessed by calculating the coefficient of variation (CV=SD*100/mean in %) of the five fold determinations. The methodological variation was expressed as deviation of diameter (mm), volume (ml) and peak wall stress (kPa) amongst the three observers. Results: Reproducibility measurements in healthy vessels of aortic diameters between 16.1mm to 16.6mm varied from CV=2.5% to CV=4.9%. Abdominal aortic volumes of 14ml to 15ml were measured in the healthy cohort with a reproducibility of CV=5.8% to CV=11.5%. Peak wall stress varied between 53 kPa and 55 kPa, where CV ranged from 3-13%. Inter-observer variation was <10% for diameter, volume and peak stress in healthy volunteers. Aortic diameter in three AAAs was measured to 58.9 mm; 54.6 mm; and 71.2 mm respectively. The coefficient of variation showed high agreement with values less than 5%. AAA volume varied between 130 ml and 300 ml (CV < 10%) and Peak wall stress was predicted between 172 kPa and 296 kPa (CV <10%). Variability between the 3 observers in AAA measurements was 0.7 mm – 6.0 mm for diameter, 11 – 28 ml for volume and 4-27 kPa for peak wall stress, respectively. Conclusions: Volume and diameter measurements based on geometrical models reconstructed from CTA scans showed quit good reproducibility for serial measurements in normal and degenerative arteries. Peak wall stress predictions exhibited high accordance between different observers, and in serial measurements within one observer. Volume and peak wall stress analysis could be an additionally module for assessment of individual rupture risk in AAA in the future, which however needs to be validated by additional studies.
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| 2. |
- Hyhlik-Dürr, A., et al.
(författare)
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Finite-Elemente-Analyse abdomineller Aortenaneurysmen : Erste Ergebnisse der Intra- und Interobserver Validierung
- 2010
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Konferensbidrag (refereegranskat)abstract
- Hintergrund: Die Therapie des abdominellen Aortenaneurysmas (AAA) ist indiziert, wenn das Rupturrisiko das Risiko der elektiven Operation übersteigt. Die Abschätzung des individuellen Rupturrisikos gilt als Basis der Indikationsstellung zur offenen oder endovaskulären Chirurgie. Bisher wird der Durchmesser des AAA als maßgeblicher Risikofaktor für die Ruptur herangezogen. Für eine sensitivere Indikationsstellung sollten jedoch andere morphologische oder biomechanische Faktoren wie die Volumenveränderung im Verlauf und/oder die Wandspannung im Aneurysma untersucht werden. Ziel dieser Studie ist die Analyse der Reproduzierbarkeit der Durchmesserbestimmung sowie der Volumen- und Wandspannungsberechnung anhand eines geometrischen Modells, basierend auf der Finite Elemente Methode. Methode: Computertomographische Daten von vier gesunden und zehn Patienten mit infrarenalen abdominellen Aneurysmen werden von drei unabhängigen Untersuchern analysiert. Die abdominelle Aorta wird semiautomatisch von Computertomographie-Angiographie (CTA) Bilddaten segmentiert, wobei zwei und drei-dimensionale aktive Konturmodelle, wie sie aus der Bildverarbeitung bekannt sind, zum Einsatz kommen. Der maximale Durchmesser (cernterline-basiert) sowie das aortale Volumen werden aus den rekonstruierten dreidimensionalen Modellen berechnet. Zusätzlich werden nicht-lineare Finite Elemente Modelle verwendet, um die mechanische Spannung in der Aortenwand zwischen der Aortenbifurkation und den Nierenarterien zu bestimmen. Zu diesen Zweck wird der mittlere arterielle Druck als Belastung angenommen und nicht-lineare isotrope Materialmodelle erfassen die mechanischen Eigenschaften der Aortenwand und des Thrombusgewebes. Die Intra- und Interobserver Variabilität der fünf Messungen des maximalen Durchmessers, des Volumens und der maximalen Wandspannung wurden durch die Berechnung des Variationskoeffizienten (CV=SD*100/Arithmethisches Mittel in %) ausgedrückt. Die methodische Variation berechnet sich aus der Abweichung des Duchmessers (mm), des Volumens (ml) und der maximalen Wandspannung (kPA) zwischen den drei Untersuchern. Ergebnisse: Die Reproduzierbarkeit gesunder Gefäßen lag bei einem Durchmesser zwischen 16.1mm und 16.6mm zwischen CV=2,5% und CV=4,9%. Das aortale Volumen lag zwischen 14ml und 15ml, die Reproduzierbarkeit bei den gesunden Gefäßen streute zwischen CV=5.8% und CV=11.5%. Die maximale Wandspannung variierte zwischen 53 kPA and 55 kPa, der CV% lag hierbei zwischen 3 und 13. Die Interobserver Variabilität lag < 10% für den Durchmesser, die Volumenbestimmung und die Bestimmung der maximale Wandspannung. Der maximale Durchmesser der Aorta bei 3 Patienten mit infrarenalem Aneurysma wurde mit durchschnittlich 58.9mm, 54.6mm und 71.2mm berechnet (Stand bei Abstracteinreichung). Der Variationskoeffizient zeigte dabei eine hohe Übereinstimmung mit Werten unter 5%. Das Volumen der Aneurysmen schwankte zwischen 130 ml und 300 ml (CV<10%), die berechnete Wandspannung lag zwischen 172 kPA und 296 kPA (CV<10%). Die Variabilität zwischen den drei Untersuchern betrug 0,7-6,0 mm für den Durchmesser, 11-28 ml für das Volumen und 4-27 kPA für die maximale Wandspannung. Zusammenfassung: Sowohl an gesunden als auch an degenerativ veränderten Gefäßen ergibt die Reproduzierbarkeit des Aortendurchmessers und des aortalen Volumens basierend auf dem dreidimensionalen rekonstruierten Modellen eine hohe Übereinstimmung. Die berechnete Wandspannung basierend auf den Finiten Elemente Modellen zeigt einen geringen Grad an Variabilität sowohl zwischen verschiedenen Untersuchern als auch bei wiederholter Messung. Daher könnten die Volumenbestimmung und die Analyse der Wandspannung zusätzliche Größen bei der Bestimmung des individuellen Rupturrisikos bei Patienten mit Aortenaneurysmen darstellen, um eine präzisere Indikationsstellung zu ermöglichen.
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| 3. |
- Martufi, Giampaolo, 1980-
(författare)
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Biomechanics of abdominal aortic aneurysm:Experimental evidence and multiscale constitutive modeling
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The reliable assessment of Abdominal Aortic Aneurysm (AAA) rupture risk is critically important in reducing related mortality without unnecessarily increasing the rate of elective repair. A multi-disciplinary approach including vascular biomechanics and constitutive modeling is needed to better understand and more effectively treat these diseases. AAAs are formed through irreversible pathological remodeling of the vascular wall and integrating this biological process in the constitutive description could improve the current understanding of this disease as well as the predictability of biomechanical simulations.First in this thesis, multiple centerline-based diameter measurements between renal arteries and aortic bifurcation have been used to monitor aneurysm growth of in total 51 patients from Computer Tomography-Angiography (CT-A) data. Secondly, the thesis proposes a novel multi-scale constitutive model for the vascular wall, where collagen fibers are assembled by proteoglycan cross-linked collagen fibrils and reinforce an otherwise isotropic matrix (elastin). Collagen fibrils are dynamically formed by a continuous stretch-mediated process, deposited in the current configuration and removed by a constant degradation rate. The micro-plane concept is then used for the Finite Element (FE) implementation of the constitutive model. Finally, histological slices from intra-luminal thrombus (ILT) tissue were analyzed using a sequence of automatic image processing steps. Derived microstructural data were used to define Representative Volume Elements (RVEs), which in turn allowed the estimation of microscopic material properties using the non-linear FE.The thesis showed that localized spots of fast diameter growth can be detected through multiple centerline-based diameter measurements all over the AAA sac. Consequently, this information might further reinforce the quality of aneurysm surveillance programs. The novel constitutive model proposed in the thesis has a strong biological motivation and provides an interface with biochemistry. Apart from modeling the tissue’s passive response, the presented model is helpful to predict saline feature of aneurysm growth and remodeling. Finally, the thesis provided novel microstructural and micromechanical data of ILT tissue, which is critically important to further explore the role of the ILT in aneurysm rupture.
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| 4. |
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| 5. |
- Gasser, T. Christian
(författare)
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An irreversible constitutive model for fibrous soft biological tissue : A 3-D microfiber approach with demonstrative application to abdominal aortic aneurysms
- 2011
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Ingår i: ACTA BIOMATERIALIA. - : Elsevier BV. - 1742-7061. ; 7:6, s. 2457-2466
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Tidskriftsartikel (refereegranskat)abstract
- Understanding the failure and damage mechanisms of soft biological tissue is critical to a sensitive and specific characterization of tissue injury tolerance and its relation to biological responses. Despite increasing experimental and analytical efforts, failure-related irreversible effects of soft biological tissue are still poorly understood. There is still no clear definition of what "damage" of a soft biological material is, and conventional macroscopic indicators, as known from damage of engineering materials for example, may not identify the tissue's tolerance to injury appropriately. To account for the complex three-dimensional arrangement of collagen, a microfiber model approach is applied, where constitutive relations for collagen fibers are integrated over the unit sphere, which in turn defines the tissue's macroscopic properties. A collagen fiber is represented by a bundle of proteoglycan cross-linked collagen fibrils that undergoes irreversible deformations when exceeding its elastic tensile limit. The proposed constitutive model is able to predict strain stiffening at physiological strain levels and does not exhibit a clear macroscopic elastic limit, two typical features known from soft biological tissue testing. An elastic-predictor/plastic-corrector implementation of the model is followed and constitutive parameters are estimated from in vitro test data from a particular abdominal aortic aneurysm (AAA). Damage-based structural instabilities of the AAA under different inflation conditions are investigated, where the collagen orientation density has been estimated from its in vivo stress state.
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| 6. |
- Biasetti, Jacopo, et al.
(författare)
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Blood flow and coherent vortices in the normal and aneurysmatic aortas : a fluid dynamical approach to intraluminal thrombus formation
- 2011
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Ingår i: Journal of the Royal Society Interface. - : The Royal Society. - 1742-5689 .- 1742-5662. ; 8:63, s. 1449-1461
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Tidskriftsartikel (refereegranskat)abstract
- Abdominal aortic aneurysms (AAAs) are frequently characterized by the development of an intra-luminal thrombus (ILT), which is known to have multiple biochemical and biomechanical implications. Development of the ILT is not well understood, and shear-stress-triggered activation of platelets could be the first step in its evolution. Vortical structures (VSs) in the flow affect platelet dynamics, which motivated the present study of a possible correlation between VS and ILT formation in AAAs. VSs educed by the lambda(2)-method using computational fluid dynamics simulations of the backward-facing step problem, normal aorta, fusiform AAA and saccular AAA were investigated. Patient-specific luminal geometries were reconstructed from computed tomography scans, and Newtonian and Carreau-Yasuda models were used to capture salient rheological features of blood flow. Particularly in complex flow domains, results depended on the constitutive model. VSs developed all along the normal aorta, showing that a clear correlation between VSs and high wall shear stress (WSS) existed, and that VSs started to break up during late systole. In contrast, in the fusiform AAA, large VSs developed at sites of tortuous geometry and high WSS, occupying the entire lumen, and lasting over the entire cardiac cycle. Downward motion of VSs in the AAA was in the range of a few centimetres per cardiac cycle, and with a VS burst at that location, the release (from VSs) of shear-stress-activated platelets and their deposition to the wall was within the lower part of the diseased artery, i.e. where the thickest ILT layer is typically observed. In the saccular AAA, only one VS was found near the healthy portion of the aorta, while in the aneurysmatic bulge, no VSs occurred. We present a fluid-dynamics-motivated mechanism for platelet activation, convection and deposition in AAAs that has the potential of improving our current understanding of the pathophysiology of fluid-driven ILT growth.
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| 7. |
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| 8. |
- Erhart, P., et al.
(författare)
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Finite-Elemente-Analyse abdomineller Aortenaneurysmen : Aktuelle Wertigkeit als Ergänzung zur herkömmlichen Diagnostik
- 2015
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Ingår i: Gefässchirurgie. - : Springer Science and Business Media LLC. - 0948-7034 .- 1434-3932. ; 20:7, s. 503-507
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Tidskriftsartikel (refereegranskat)abstract
- Finite element analysis (FEA) of abdominal aortic aneurysms (AAA) could enable a more precise patient-specific risk assessment of AAA rupture. Further clinical studies are needed to validate this model as a clinical decision-making tool. The A4clinics™ software provides a simple and detailed FEA simulation. After implementation of a FEA workstation in a high volume university vascular center, relevant studies for further model validation are expected to be carried out.
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| 9. |
- Federico, Salvatore, et al.
(författare)
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Nonlinear elasticity of biological tissues with statistical fibre orientation
- 2010
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Ingår i: Journal of the Royal Society Interface. - : The Royal Society. - 1742-5689 .- 1742-5662. ; 7:47, s. 955-966
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Tidskriftsartikel (refereegranskat)abstract
- The elastic strain energy potential for nonlinear fibre-reinforced materials is customarily obtained by superposition of the potentials of the matrix and of each family of fibres. Composites with statistically oriented fibres, such as biological tissues, can be seen as being reinforced by a continuous infinity of fibre families, the orientation of which can be represented by means of a probability density function defined on the unit sphere (i.e. the solid angle). In this case, the superposition procedure gives rise to an integral form of the elastic potential such that the deformation features in the integral, which therefore cannot be calculated a priori. As a consequence, an analytical use of this potential is impossible. In this paper, we implemented this integral form of the elastic potential into a numerical procedure that evaluates the potential, the stress and the elasticity tensor at each deformation step. The numerical integration over the unit sphere is performed by means of the method of spherical designs, in which the result of the integral is approximated by a suitable sum over a discrete subset of the unit sphere. As an example of application, we modelled the collagen fibre distribution in articular cartilage, and used it in simulating displacement-controlled tests: the unconfined compression of a cylindrical sample and the contact problem in the hip joint.
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| 10. |
- Forsell, Caroline, et al.
(författare)
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Impact of material anisotropy on deformation of myocardial tissue due to pacemaker electrodes
- 2011
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Ingår i: ASME 2011 Summer Bioengineering Conference, SBC 2011. - 9780791854587 ; , s. 789-790
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Konferensbidrag (refereegranskat)abstract
- A Pacemaker electrode can penetrate the heart wall, and to design a penetration-resistent lead tip sound knowledge regarding failure of ventricular tissue is required. Numerical simulations can be particular helpful in that respect, but depend on a reliable constitutive description for ventricular tissue. In this study an anisotropic hyperelastic model for the myocardium has been implemented and compared to predictions from an isotropic description. Specifically, the response due to pushing a rigid punch into the myocardium was studied. Results between anisotropic and isotropic descriptions of the myocardium differed significantly, which justified the implementation of an anisotropic model for the myocardium.
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