TY - JOUR
T1 - Impact of Postthrombotic Vein Wall Biomechanics on Luminal Flow during Venous Angioplasty and Stent Placement
T2 - Computational Modeling Results
AU - Li, Ningcheng
AU - Ferracane, Jack
AU - Andeen, Nicole
AU - Lewis, Steven
AU - Woltjer, Randy
AU - Rugonyi, Sandra
AU - Jahangiri, Younes
AU - Uchida, Barry
AU - Farsad, Khashayar
AU - Kaufman, John A.
AU - Al-Hakim, Ramsey
N1 - Funding Information:
N.L. reports grants from SIR Foundation , during the conduct of the study. S.R. is the president of CirSym Inc., a startup company devoted to developing software related to cardiovascular disease; however, CirSym software or developments were not employed in the current article. K.F. is the cofounder of and has equity interest in Auxetics Inc.; receives personal fees from Cook Medical, BTG, Neuwave, Guerbet LLC, Genentech, Dova Pharmaceuticals, Eisai, and Inquis Medical Inc.; grants from Guerbet LLC and WL Gore; and has a pending patent for “use of specific stent class for the management of venous stenosis.” J.A.K. reports grants from National Institutes of Health ; personal fees from VIVA Physicians, Cook Medical, and Argon; receives book royalties and journal editor stipend from Elsevier; is the owner of Hatch Medical, Vu Medi, Endoshape, and Auxetics; is on the medical board of Modyx.ai; and has a pending patent for “auxetic stents for managing venous stenosis.” R.A.-H. reports grants from SIR Foundation; is the cofounder of and has equity interest in Auxetics Inc.; receives personal fees from Penumbra; and has a pending patent for “auxetic stents for managing venous stenosis.” None of the other authors have identified a conflict of interest.
Funding Information:
N.L. reports grants from SIR Foundation, during the conduct of the study. S.R. is the president of CirSym Inc., a startup company devoted to developing software related to cardiovascular disease; however, CirSym software or developments were not employed in the current article. K.F. is the cofounder of and has equity interest in Auxetics Inc.; receives personal fees from Cook Medical, BTG, Neuwave, Guerbet LLC, Genentech, Dova Pharmaceuticals, Eisai, and Inquis Medical Inc.; grants from Guerbet LLC and WL Gore; and has a pending patent for ?use of specific stent class for the management of venous stenosis.? J.A.K. reports grants from National Institutes of Health; personal fees from VIVA Physicians, Cook Medical, and Argon; receives book royalties and journal editor stipend from Elsevier; is the owner of Hatch Medical, Vu Medi, Endoshape, and Auxetics; is on the medical board of Modyx.ai; and has a pending patent for ?auxetic stents for managing venous stenosis.? R.A.-H. reports grants from SIR Foundation; is the cofounder of and has equity interest in Auxetics Inc.; receives personal fees from Penumbra; and has a pending patent for ?auxetic stents for managing venous stenosis.? None of the other authors have identified a conflict of interest.
Publisher Copyright:
© 2021 SIR
PY - 2022/3
Y1 - 2022/3
N2 - This study characterized the impact of vein wall biomechanics on inflow diameter and luminal flow during venous angioplasty and stent placement, using postthrombotic and healthy biomechanical properties from an ovine venous stenosis and thrombosis model. Finite element analysis demonstrated more pronounced inflow channel narrowing in the postthrombotic vein compared with the healthy control vein during angioplasty and stent placement (relative inflow diameter reduction of 42% versus 13%, P < .0001). Computational fluid dynamics modeling showed increased relative areas of low wall shear rate in the postthrombotic vein compared with the normal vein (0.46 vs 0.24 for shear rate < 50 s−1; 0.13 vs 0.07 for shear rate < 15 s−1; P < .05), with flow stagnation and recirculation. Since inflow narrowing and low wall shear rate are associated with in-stent restenosis and reintervention, these computational results based on experimentally obtained biomechanical values highlight the significance of postthrombotic venous properties in optimizing venous intervention outcomes.
AB - This study characterized the impact of vein wall biomechanics on inflow diameter and luminal flow during venous angioplasty and stent placement, using postthrombotic and healthy biomechanical properties from an ovine venous stenosis and thrombosis model. Finite element analysis demonstrated more pronounced inflow channel narrowing in the postthrombotic vein compared with the healthy control vein during angioplasty and stent placement (relative inflow diameter reduction of 42% versus 13%, P < .0001). Computational fluid dynamics modeling showed increased relative areas of low wall shear rate in the postthrombotic vein compared with the normal vein (0.46 vs 0.24 for shear rate < 50 s−1; 0.13 vs 0.07 for shear rate < 15 s−1; P < .05), with flow stagnation and recirculation. Since inflow narrowing and low wall shear rate are associated with in-stent restenosis and reintervention, these computational results based on experimentally obtained biomechanical values highlight the significance of postthrombotic venous properties in optimizing venous intervention outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85124880460&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85124880460&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2021.12.006
DO - 10.1016/j.jvir.2021.12.006
M3 - Article
C2 - 35221046
AN - SCOPUS:85124880460
SN - 1051-0443
VL - 33
SP - 262
EP - 267
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 3
ER -