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Patient-specific compliant simulation framework informed by 4DMRI-ex-tracted pulse wave Velocity: Application post-TEVAR

Girardin, Louis; Lind, Niklas; von Tengg-Kobligk, Hendrik; Balabani, Stavroula; Diaz-Zuccarini, Vanessa; (2024) Patient-specific compliant simulation framework informed by 4DMRI-ex-tracted pulse wave Velocity: Application post-TEVAR. Journal of Biomechanics , 175 , Article 112266. 10.1016/j.jbiomech.2024.112266. Green open access

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Abstract

We introduce a new computational framework that utilises Pulse Wave Velocity (PWV) extracted directly from 4D flow MRI (4DMRI) to inform patient-specific compliant computational fluid dynamics (CFD) simulations of a Type-B aortic dissection (TBAD), post-thoracic endovascular aortic repair (TEVAR). The thoracic aortic geometry, a 3D inlet velocity profile (IVP) and dynamic outlet boundary conditions are derived from 4DMRI and brachial pressure patient data. A moving boundary method (MBM) is applied to simulate aortic wall displacement. The aortic wall stiffness is estimated through two methods: one relying on area-based distensibility and the other utilising regional pulse wave velocity (RPWV) distensibility, further fine-tuned to align with in vivo values. Predicted pressures and outlet flow rates were within 2.3 % of target values. RPWV-based simulations were more accurate in replicating in vivo hemodynamics than the area-based ones. RPWVs were closely predicted in most regions, except the endograft. Systolic flow reversal ratios (SFRR) were accurately captured, while differences above 60 % in in-plane rotational flow (IRF) between the simulations were observed. Significant disparities in predicted wall shear stress (WSS)-based indices were observed between the two approaches, especially the endothelial cell activation potential (ECAP). At the isthmus, the RPWV-driven simulation indicated a mean ECAP>1.4 Pa-1 (critical threshold), indicating areas potentially prone to thrombosis, not captured by the area-based simulation. RPWV-driven simulation results agree well with 4DMRI measurements, validating the proposed pipeline and facilitating a comprehensive assessment of surgical decision-making scenarios and potential complications, such as thrombosis and aortic growth.

Type: Article
Title: Patient-specific compliant simulation framework informed by 4DMRI-ex-tracted pulse wave Velocity: Application post-TEVAR
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jbiomech.2024.112266
Publisher version: http://dx.doi.org/10.1016/j.jbiomech.2024.112266
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Technology, Biophysics, Engineering, Biomedical, Engineering, CFD, Type-B Aortic Dissection, Pulse Wave Velocity, 4DMRI, Compliant Simulation, B AORTIC DISSECTION, MECHANICAL-PROPERTIES, ENDOVASCULAR REPAIR, FLOW, MRI
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
URI: https://discovery.ucl.ac.uk/id/eprint/10197502
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