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Influence of balloon design, plaque material composition, and balloon sizing on acute post angioplasty outcomes: An implicit finite element analysis
International Journal for Numerical Methods in Biomedical Engineering ( IF 2.1 ) Pub Date : 2021-05-17 , DOI: 10.1002/cnm.3499
Bernard Helou 1 , Aline Bel-Brunon 2 , Claire Dupont 1 , Wenfeng Ye 3 , Claudio Silvestro 4 , Michel Rochette 3 , Antoine Lucas 1 , Adrien Kaladji 1 , Pascal Haigron 1
Affiliation  

In this work we propose a generic modeling approach for simulating percutaneous transluminal angioplasty (PTA) endovascular treatment, and evaluating the influence of balloon design, plaque composition, and balloon sizing on acute post-procedural outcomes right after PTA, without stent implantation. Clinically-used PTA balloons were classified into two categories according to their compliance characteristics, and were modeled correspondingly. Self-defined elastoplastic constitutive laws were implemented within the plaque and artery models, after calibration based on experimental and clinical data. Finite element method (FEM) implicit solver was used to simulate balloon inflation and deflation. Besides balloon profile at max inflation, results are mainly assessed in terms of the elastic recoil ratio (ERR) and lumen gain ratio (LGR) obtained immediately after PTA. No variations in ERR nor LGR values were detected when the balloon design changed, despite the differences observed in their profile at max inflation. Moreover, LGR and ERR inversely varied with the augmentation of calcification level within the plaque (−11% vs. +4% respectively, from fully lipidic to fully calcified plaque). Furthermore, results showed a direct correlation between balloon sizing and LGR and ERR, with noticeably higher rates of change for LGR (+18% and +2% for LGR and ERR respectively for a calcified plaque and a balloon pressure increasing from 10 to 14 atm). However a larger LGR comes with a higher risk of arterial rupture. This proposed methodology opens the way for evaluation of angioplasty balloon selections towards clinical procedure optimization.

中文翻译:

球囊设计、斑块材料成分和球囊尺寸对急性血管成形术后结果的影响:隐式有限元分析

在这项工作中,我们提出了一种通用建模方法,用于模拟经皮腔内血管成形术 (PTA) 血管内治疗,并评估球囊设计、斑块组成和球囊尺寸对 PTA 后急性术后结果的影响,无需支架植入。临床上使用的PTA球囊根据其顺应性特征分为两类,并相应建模。根据实验和临床数据校准后,在斑块和动脉模型中实施自定义弹塑性本构法则。有限元法 (FEM) 隐式求解器用于模拟气球充气和放气。除了最大膨胀时的气球轮廓,结果主要根据 PTA 后立即获得的弹性回弹比 (ERR) 和流明增益比 (LGR) 进行评估。当气球设计改变时,没有检测到 ERR 和 LGR 值的变化,尽管在最大充气时观察到它们的轮廓存在差异。此外,LGR 和 ERR 与斑块内钙化水平的增加呈负相关(分别为 -11% 与 +4%,从完全脂质斑块到完全钙化斑块)。此外,结果显示球囊尺寸与 LGR 和 ERR 之间存在直接相关性,LGR 的变化率明显更高(钙化斑块的 LGR 和 ERR 分别为 +18% 和 +2%,球囊压力从 10 atm 增加到 14 atm )。然而,更大的 LGR 伴随着更高的动脉破裂风险。
更新日期:2021-05-17
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