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To investigate the effects of clinical modalities and configurations on oxygenator pressure loss (ΔP), oxygen transfer ability and thrombosis risk and to find out the optimal oxygenator configuration. Modified partial pressure of oxygen (PO2) and a newly proposed thrombosis risk model (constructed from platelets, coagulation factors, hemostatic proteins, and blood stagnation) were used for this study. Oxygen transport and thrombosis risk assessment experiments were used for validation. Both simulation and experimental results indicate that when oxygenator operates at low flow rates with low-pressure loss and high PO2, they produced thrombin concentrations and increased thrombosis risk. For the same membrane fiber region, variations in the oxygenator external structure did not affect PO2 and thrombin production. For the ΔP and thrombosis risk, square oxygenators > round oxygenators, single-inlet oxygenators > multiple-inlet oxygenators, and lower inlet and lower outlet oxygenators > center inlet and center outlet oxygenators. The oxygenator high thrombosis risk region was identified as the blood-to-blood/border impingement region. A study of 81 oxygenator inlet and outlet combinations found that the inlet and outlet locations had little effect on ΔP and PO2. Oxygenator thrombosis risk was the lowest when using a center inlet and an upper/lower outlet configuration. The accuracy of the thrombosis risk model was validated. The oxygenator operation mode had a significant effect on ΔP, PO2, and thrombosis risk. Changes in the oxygenator external configuration had a significant impact on thrombosis. The lowest thrombosis risk was found in the center inlet and upper/lower outlet round oxygenator configuration. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the relationship between the morphological structure and hemodynamic properties of the compressed iliac vein and explore the reason for the formation of thrombosis in the compressed iliac vein. Materials and Methods: A total of 11 patients with iliac vein compression syndrome (IVCS) were included in this study, and their iliac veins were reconstructed in 3 dimensions (3D). The morphological structures of the iliac veins (confluence angle, degree of stenosis) were analyzed based on the 3D model. Variations in the hemodynamic properties of the iliac vein were investigated at 4 typical moments in one cardiac cycle, and the relationship between the different morphological configurations and the pressure difference was investigated. Results: In the region of the compressed iliac vein, the blood flow velocity is accelerated and the pressure changes abruptly accompanied by the increase in pressure difference. Higher time averaged wall shear stress (TAWSS) and lower relative residence time (RRT) appeared in stenosis regions of compressed iliac vein, while TAWSS was low and RRT was large near the stenosis position. There was a strong positive correlation between the degree of stenosis and the pressure difference (r=0.894), and a positive correlation between the confluence angle of the iliac vein and the pressure difference (r=0.638). Conclusion: The morphological structure of the compressed iliac vein has an obvious influence on the hemodynamic surroundings; the pressure difference becomes larger when the degree of stenosis and the confluence angle increase. The iliac vein luminal areas with low TAWSS and high RRT near the compressed location can impede blood flow and lead to accumulation of blood components, which may increase the risk of thrombosis formation and should be fully considered in the treatment of IVCS. [ABSTRACT FROM AUTHOR]

An abdominal aortic aneurysm (AAA) is a typical aortic disease with serious complications. In clinical practice, the decision to intervene in treatment depends on the rupture risk of AAA. Therefore, monitoring the progression of the disease and accurately assessing the rupture risk is of great importance for its treatment. Studies have shown that the biomechanical indicators based on multi-scale models are more effective in accurately assessing the rupture risk of AAA. However, using computational fluid dynamics (CFD) to simulate the biomechanical environment is a cumbersome and time-consuming process, which is inadequate to meet the needs of clinical monitoring and quick decisions. While the hemodynamic environment of AAA is heavily dependent on geometry, more and more biomechanics-related morphological parameters have been raised and validated. In this review, we summarized typical morphological parameters associated with AAA rupture and their relationships with the mechanical environment, including maximum diameter, deformation rate, saccular index, asymmetry, AAA volume, tortuosity, and intraluminal thrombus (ILT), providing a reference for clinical preoperative risk assessment. Clinical Impact: Studies have shown that the biomechanical indicators based on multi-scale models are more effective in accurately assessing the rupture risk of AAA. To meet the need for clinical monitoring and rapid decision making, the typical morphological parameters associated with AAA rupture and their relationships with the mechanical environment have been summarized, which provide a reference for clinical preoperative risk assessment of AAA. [ABSTRACT FROM AUTHOR]

Women with abdominal aortic aneurysm (AAA) have a higher incidence of complications after Endovascular aneurysm repair (EVAR), most of which are related to the migration of stent‐graft. The different force acting on the stent‐graft after EVAR caused by different abdominal artery anatomy of male and female AAA patients may be the reason for the sex‐different complications. This article aims to explore the possible biomechanical mechanisms of sex differences by making a comparison of displacement force acting on the stent graft of male and female AAA patients. To explore the effect of different vascular anatomy on stent‐graft migration, the uniformed models were constructed according to the specific vascular anatomy parameters of AAA patients of different sex, which have been measured before. The computational fluid dynamics method was used to quantitate the pulsatile force acting on the stent‐graft after EVAR in a cardiac cycle. Then the displacement force was calculated with the pressure and the wall shear stress, and the total and area‐weighted average of displacement force acting on the stent‐graft were compared respectively. In one cardiac cycle, the wall pressure for the male model is greater than that of the female model (2.7–4.4 vs. 2.2–3.4 N), and the wall shear force for the female model is slightly greater (0–0.0065 vs. 0–0.0055 N). The displacement force is mainly provided by the wall pressure, which is also greater in the male model. However, the area‐averaged displacement force is greater for the female model than that for the male model (180–290 vs. 160–250 Pa). Because of the different vascular anatomies, the impact caused by the pulsating aortic blood flow on the AAA stent‐graft of women after EVAR was greater than that of men. Women's vascular anatomy leads to greater area‐averaged displacement force after stent‐graft implantation, resulting in a greater risk of stent‐graft migration, which might be one of the reasons why women had a higher incidence of complications after EVAR. [ABSTRACT FROM AUTHOR]

To investigate the effect of rotor design configuration on hemodynamic features, hemocompatibility and dynamic balance of blood pumps. Computational fluid dynamics was employed to investigate the effects of rotor type (closed impeller, semi‐open impeller), clearance height and back vanes on blood pump performance. In particular, the Eulerian hemolysis model based on a power‐law function and the Lagrangian thrombus model with integrated stress accumulation and residence time were applied to evaluate the hemocompatibility of the blood pump. This study shows that compared to the closed impeller, the semi‐open impeller can improve hemolysis at a slight sacrifice in head pressure, but increase the risk of thrombogenic potential and disrupt rotor dynamic balance. For the semi‐open impeller, the pressure head, hemolysis, and axial thrust of the blood pump decrease with increasing front clearance, and the risk of thrombosis increases first and then decreases with increasing front clearance. Variations in back clearance have little effect on pressure head, but larger on back clearance, worsens hemolysis, thrombogenic potential and rotor dynamic balance. The employment of back vanes has little effect on the pressure head. All back vanes configurations have an increased risk of hemolysis in the blood pump but are beneficial for the improvement of the rotor dynamic balance of the blood pump. Reasonable back vanes configuration (higher height, wider width, longer length and more number) decreases the flow separation, increases the velocity of blood in the back clearance, and reduces the risk of blood pooling and thrombosis. It was also found that hemolysis index (HI) was highly negatively correlated with pressure difference between the top and back clearances (r = −.87), and thrombogenic potential was positively correlated with pressure difference between the top and back clearances (r =.71). This study found that rotor type, clearance height, and back vanes significantly affect the hydraulic performance, hemocompatibility and rotor dynamic balance of centrifugal blood pumps through secondary flow. These parameters should be carefully selected when designing and optimizing centrifugal blood pumps for improving the blood pump clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: The centrifugal blood pump volute has a significant impact on its hemodynamic performance hemocompatibility. Previous studies about the effect of volute design features on the performance of blood pumps are relatively few. Methods: In the present study, the computational fluid dynamics (CFD) method was utilized to evaluate the impact of volute design factors, including spiral start position, volute tongue radius, inlet height, size, shape and diffuser pipe angle on the hemolysis index and thrombogenic potential of the centrifugal blood pump. Results: Correlation analysis shows that flow losses affect the hemocompatibility of the blood pump by influencing shear stress and residence time. The closer the spiral start position of the volute, the better the hydraulic performance and hemocompatibility of the blood pump. Too large or too small volute inlet heights can worsen hydraulic performance and hemolysis, and higher volute inlet height can increase the thrombogenic potential. Small volute sizes exacerbate hemolysis and large volute sizes increase the thrombogenic risk, but volute size does not affect hydraulic performance. When the diffuser pipe is tangent to the base circle of the volute, the best hydraulic performance and hemolysis performance of the blood pump is achieved, but the thrombogenic potential is increased. The trapezoid volute has poor hydraulic performance and hemocompatibility. The round volute has the best hydraulic and hemolysis performance, but the thrombogenic potential is higher than that of the rectangle volute. Conclusion: This study found that the hemolysis index shows a significant correlation with spiral start position, volute size, and diffuser pipe angle. Thrombogenic potential exhibits a good correlation with all the studied volute design features. The flow losses affect the hemocompatibility of the blood pump by influencing shear stress and residence time. The finding of this study can be used to guide the optimization of blood pump for improving the hemodynamic performance and hemocompatibility. [ABSTRACT FROM AUTHOR]