Device Design for Treatment of Aortic Disease

该项目的总体目标是提供一套工具来评估用于主动脉疾病血管内修复的设备的性能。血管内治疗的应用激增。然而，关于植入设备的重要特征应该是什么，几乎没有科学指导。该项目将提供确定器械特性对血流动力学影响的工具，并将协助确定最适合每个患者的设计。该项目的主要目的是扩展我们的计算流体动力学能力，以便快速描述和评估用于治疗腹主动脉动脉瘤的设备上的血流动力学力。仿真软件的验证将由创新的成像技术提供。将开发数值算法来描述介入之前和之后的模拟装置插入血管中的血流动力学。这些能力将允许评估倾向于导致支架移植物迁移或拆卸的力。它还将提供能力，以减少可能性，将有明显的再循环的地区，潜在的血栓形成。先进的成像方法将用于在心脏周期的多个点上提供腔室表面的完整描述。磁共振成像脉冲序列设计、射频线圈和造影剂的使用将得到改进，以提供这种能力。此外，为了建立数值计算的边界条件，将在干预前使用磁共振测速仪测量流速。最后，将招募一组计划进行AAA修复的患者，并将患者特异性血流动力学计算结果与器械构象的时间变化进行比较。该项目是成像科学家、流体动力学工程师和临床医生之间的合作成果。它将提供一个系统的工程框架，在其中可以改进介入装置的设计和功能。设备故障的潜在来源将被识别和消除。这些改进将使未来几年可能接受血管内支架移植治疗的大量患者受益。

The overall goal of this project is to provide a set of tools for evaluating the performance of devices that are used in the endovascular repair of aortic disease. There has been a surge in the application of endovascular treatment. However, there is little scientific guidance on what the important features of an implanted device should be. This project will provide the tools for determining the hemodynamic impact of device characteristics and will assist in determining the most suitable design on a patient-by-patient basis. The primary aim of this project is to extend our Computational Fluid Dynamics capabilities for the rapid description and evaluation of hemodynamic forces on devices used for treating aneurysms of the abdominal aorta. Validation of the simulation software will be provided by innovative imaging techniques. Numerical algorithms will be developed to describe the hemodynamics in the vasculature before intervention and following the simulated insertion of a device. These capabilities will permit the assessment of the forces that tend to cause a stent- graft to migrate or to disassemble. It will also provide the ability to reduce the likelihood that there will be regions of pronounced recirculation with potential for thrombus formation. Advanced imaging methods will be used to provide a full description of the lumenal surface at multiple points through the cardiac cycle. Improvements in Magnetic Resonance Imaging pulse sequence design, radio frequency coils, and the use of contrast agents will be pursued to provide this capability. In addition, to establish boundary conditions for the numerical computations, flow velocities will be measured pre intervention using Magnetic Resonance Velocimetry. Finally, a cohort of patients scheduled for AAA repair will be recruited and the results of patient- specific computations of hemodynamic forces will be compared to temporal changes in device conformation. This project is a collaborative effort between imaging scientists, fluid dynamics engineers, and clinicians. It will provide a systematic engineering framework in which the design and function of interventional devices can be improved. Potential sources of device failure will be identified and eliminated. These improvements will benefit the large numbers of individuals who are likely to receive treatment with endovascular stent-grafts in the coming years.