From 4D Medical Images (CT, MRI, and Ultrasound) to 4D Structured Mesh Models of the Left Ventricular Endocardium for Patient-Specific Simulations.

With cardiovascular disease (CVD) remaining the primary cause of death worldwide, early detection of CVDs becomes essential. The intracardiac flow is an important component of ventricular function, motion kinetics, wash-out of ventricular chambers, and ventricular energetics. Coupling between Computational Fluid Dynamics (CFD) simulations and medical images can play a fundamental role in terms of patient-specific diagnostic tools.

Erratum to: An in silico biomechanical analysis of the stent-esophagus interaction.

In the original publication of the article, Tables 2 and 3 were published with error. The correct tables are provided below (Tables 2, 3). The original version of the article has also been corrected.

An in silico biomechanical analysis of the stent-esophagus interaction.

Despite all technological innovations in esophageal stent design over the past 20 years, the association between the stent design's mechanical behavior and its effect on the clinical outcome has not yet been thoroughly explored. A parametric numerical model of a commercially available esophageal bioresorbable polymeric braided wire stent is set up, accounting for stent design aspects such as braiding angle, strut material, wire thickness, degradation and friction between the wires comprising a predictive tool on the device's mechanical behavior. Combining this tool with complex multilayered numerical models of the pathological in vivo stressed, actively contracting and buckling esophagus could provide clinicians and engineers with a patient-specific window into the mechanical aspects of stent-based esophageal intervention.

Procedure to describe clavicular motion.

Background: For many years, researchers have attempted to describe shoulder motions by using different mathematical methods. The aim of this study was to describe a procedure to quantify clavicular motion.

Methods: The procedure proposed for the kinematic analysis consists of 4 main processes: 3 transcortical pins in the clavicle, motion capture, obtaining 3-dimensional bone models, and data processing.

Impact of plaque type and side branch geometry on side branch compromise after provisional stent implantation: a simulation study.

Aims: Mechanisms of lumen compromise after provisional side branch (SB) stenting are poorly understood. In this study we aimed to investigate the impact of bifurcation angle, plaque composition, and procedural strategy on SB compromise.

Methods And Results: Computer simulations of stent implantation were performed in Medina (1,1,1) bifurcation models.

Automated femoral landmark extraction for optimal prosthesis placement in total hip arthroplasty.

The automated extraction of anatomical reference landmarks in the femoral volume may improve speed, precision, and accuracy of surgical procedures, such as total hip arthroplasty. These landmarks are often hard to achieve, even via surgical incision. In addition, it provides a presurgical guidance for prosthesis sizing and placement.

Fully automatic segmentation of femurs with medullary canal definition in high and in low resolution CT scans.

Femur segmentation can be an important tool in orthopedic surgical planning. However, in order to overcome the need of an experienced user with extensive knowledge on the techniques, segmentation should be fully automatic. In this paper a new fully automatic femur segmentation method for CT images is presented.

Discriminant musculo-skeletal leg characteristics between sprint and endurance elite Caucasian runners.

Excellence in either sprinting or endurance running requires specific musculo-skeletal characteristics of the legs. This study aims to investigate the morphology of the leg of sprinters and endurance runners of Caucasian ethnicity. Eight male sprinters and 11 male endurance runners volunteered to participate in this cross-sectional study.

Patient-specific image-based computer simulation for theprediction of valve morphology and calcium displacement after TAVI with the Medtronic CoreValve and the Edwards SAPIEN valve.

Aims: Our aim was to validate patient-specific software integrating baseline anatomy and biomechanical properties of both the aortic root and valve for the prediction of valve morphology and aortic leaflet calcium displacement after TAVI.

Methods And Results: Finite element computer modelling was performed in 39 patients treated with a Medtronic CoreValve System (MCS; n=33) or an Edwards SAPIEN XT (ESV; n=6). Quantitative axial frame morphology at inflow (MCS, ESV) and nadir, coaptation and commissures (MCS) was compared between multislice computed tomography (MSCT) post TAVI and a computer model as well as displacement of the aortic leaflet calcifications, quantified by the distance between the coronary ostium and the closest calcium nodule.

A Computational Framework to Model Degradation of Biocorrodible Metal Stents Using an Implicit Finite Element Solver.

Bioresorbable stents represent an emerging technological development within the field of cardiovascular angioplasty. Their temporary presence avoids long-term side effects of non-degradable stents such as in-stent restenosis, late stent thrombosis and fatigue induced strut fracture. Several numerical modelling strategies have been proposed to evaluate the transitional mechanical characteristics of biodegradable stents using a continuum damage framework.

A Finite Element Method to Predict Adverse Events in Intracranial Stenting Using Microstents: In Vitro Verification and Patient Specific Case Study.

Clinical studies have demonstrated the efficacy of stent supported coiling for intra-cranial aneurysm treatment. Despite encouraging outcomes, some matters are yet to be addressed. In particular closed stent designs are influenced by the delivery technique and may suffer from under-expansion, with the typical effect of "hugging" the inner curvature of the vessel which seems related to adverse events.

Unstructured hexahedral mesh generation of complex vascular trees using a multi-block grid-based approach.

The trend towards realistic numerical models of (pathologic) patient-specific vascular structures brings along larger computational domains and more complex geometries, increasing both the computation time and the operator time. Hexahedral grids effectively lower the computational run time and the required computational infrastructure, but at high cost in terms of operator time and minimal cell quality, especially when the computational analyses are targeting complex geometries such as aneurysm necks, severe stenoses and bifurcations. Moreover, such grids generally do not allow local refinements.

Single String Technique for Coronary Bifurcation Stenting: Detailed Technical Evaluation and Feasibility Analysis.

Objectives: The study aimed to evaluate the adequacy and feasibility of the single string bifurcation stenting technique.

Background: Double-stent techniques may be required for complex bifurcations. Currently applied methods all have their morphological or structural limitations with respect to wall coverage, multiple strut layers, and apposition rate.

A finite element strategy to investigate the free expansion behaviour of a biodegradable polymeric stent.

Bioresorbable stents represent a promising technological development within the field of cardiovascular angioplasty because of their ability to avoid long-term side effects of conventional stents such as in-stent restenosis, late stent thrombosis and fatigue induced strut fracture. Finite element simulations have proven to present a useful research tool for the design and mechanical analysis of stents. However, biodegradable stents pose new challenges because of their transitional mechanical behaviour.

An animal-specific FSI model of the abdominal aorta in anesthetized mice.

Recent research has revealed that angiotensin II-induced abdominal aortic aneurysm in mice can be related to medial ruptures occurring in the vicinity of abdominal side branches. Nevertheless a thorough understanding of the biomechanics near abdominal side branches in mice is lacking. In the current work we present a mouse-specific fluid-structure interaction (FSI) model of the abdominal aorta in ApoE(-/-) mice that incorporates in vivo stresses.

A versatile and experimentally validated finite element model to assess the accuracy of shear wave elastography in a bounded viscoelastic medium.

The feasibility of shear wave elastography (SWE) in arteries for cardiovascular risk assessment remains to be investigated as the artery's thin wall and intricate material properties induce complex shear wave (SW) propagation phenomena. To better understand the SW physics in bounded media, we proposed an in vitro validated finite element model capable of simulating SW propagation, with full flexibility at the level of the tissue's geometry, material properties, and acoustic radiation force. This computer model was presented in a relatively basic set-up, a homogeneous slab of gelatin-agar material (4.

What if you stretch the IFU? A mechanical insight into stent graft Instructions For Use in angulated proximal aneurysm necks.

Endovascular treatment for patients with a proximal neck anatomy outside instructions for use is an ongoing topic of debate in endovascular aneurysm repair. This paper employs the finite element method to offer insight into possible adverse effects of deploying a stent graft into an angulated geometry. The effect of angulation, straight neck length and device oversize was investigated in a full factorial parametric analysis.

Provisional stenting of coronary bifurcations: insights into final kissing balloon post-dilation and stent design by computational modeling.

Objectives: This study sought to better understand and optimize provisional main vessel stenting with final kissing balloon dilation (FKBD).

Background: Main vessel stenting with FKBD is widely used, but many technical variations are possible that may affect the final result. Furthermore, most contemporary stent designs have a large cell size, making the impact of stent platform selection for this procedure unclear.

The influence of vascular anatomy on carotid artery stenting: a parametric study for damage assessment.

Carotid artery stenting is emerging as an alternative technique to surgery for the treatment of symptomatic severe carotid stenosis. Clinical and experimental evidence demonstrates that both plaque morphology and biomechanical changes due to the device implantation can be possible causes of an unsuccessful treatment. In order to gain further insights of the endovascular intervention, a virtual environment based on structural finite element simulations was built to emulate the stenting procedure on generalized atherosclerotic carotid geometries which included a damage model to quantify the injury of the vessel.

Filling the void: a coalescent numerical and experimental technique to determine aortic stent graft mechanics.

The presented study details a combined experimental and computational method to assess and compare the mechanical behavior of the main body of 4 different stent graft designs. The mechanical response to a flat plate compression and radial crimping of the devices is derived and related to geometrical and material features of different stent designs. The finite element modeling procedure is used to complement the experimental results and conduct a solution sensitivity study.

A computational study of the hemodynamic impact of open- versus closed-cell stent design in carotid artery stenting.

The aim of this study is to analyze the shape and flow changes of a patient-specific carotid artery after carotid artery stenting (CAS) performed using an open-cell (stent-O) or a closed-cell (stent-C) stent design. First, a stent reconstructed from micro-computed tomography (microCT) is virtually implanted in a left carotid artery reconstructed from CT angiography. Second, an objective analysis of the stent-to-vessel apposition is used to quantify the lumen cross-sectional area and the incomplete stent apposition (ISA).

Inspiration from nature: dynamic modelling of the musculoskeletal structure of the seahorse tail.

Technological advances are often inspired by nature, considering that engineering is frequently faced by the same challenges as organisms in nature. One such interesting challenge is creating a structure that is at the same time stiff in a certain direction, yet flexible in another. The seahorse tail combines both radial stiffness and bending flexibility in a particularly elegant way: even though the tail is covered in a protective armour, it still shows sufficient flexibility to fully function as a prehensile organ.

Virtual evaluation of stent graft deployment: a validated modeling and simulation study.

The presented study details the virtual deployment of a bifurcated stent graft (Medtronic Talent) in an Abdominal Aortic Aneurysm model, using the finite element method. The entire deployment procedure is modeled, with the stent graft being crimped and bent according to the vessel geometry, and subsequently released. The finite element results are validated in vitro with placement of the device in a silicone mock aneurysm, using high resolution CT scans to evaluate the result.