Polymeric embolization coil of bilayered polyvinyl alcohol strand for therapeutic vascular occlusion: a feasibility study in canine experimental vascular models.

PURPOSE: To investigate the feasibility of polyvinyl alcohol (PVA) polymer coil as a new endovascular embolic agent and to gauge the related histologic response in a canine vascular model. MATERIALS AND METHODS: PVA polymer coil was fabricated by cross-linking PVA and tantalum particles. Basic properties were then studied in vitro via swelling ratio and bending diameter. Normal renal segmental arteries and wide-necked aneurysms of carotid sidewalls served as canine vascular models. Endovascular PVA coil embolization of normal renal segmental arteries (N = 20) and carotid aneurysms (N = 8) was performed under fluoroscopic guidance in 10 dogs. Degree of occlusion was assessed immediately and at 4 weeks after embolization by conventional and computed tomographic angiography. Histologic features were also graded at acute (day 1, six segmental arteries and four aneurysms) and chronic phases (week 4, 14 segmental arteries and four aneurysms) after embolization to assess inflammation, organization of thrombus, and neointimal proliferation. RESULTS: Swelling ratio declined as concentrations of cross-linking agent increased. Mean bending diameters were 2.05 mm (range, 0.86-6.25 mm) in water at 37 °C and 2.29 mm (range, 0.94-6.38 mm) in canine blood samples at 37 °C. Occlusion of normal renal segmental arteries was sustained (complete occlusion at day 1, n = 20; at week 4, n = 14), whereas immediate outcomes in carotid aneurysms (day 1, complete occlusion, n = 5; residual neck only, n = 3) were not sustained (week 4, complete occlusion, n = 1; minor recanalization, n = 1; major recanalization, n = 2). At week 4, chronic inflammatory cells predominated, with progressive organization of thrombus and fibrocellular ingrowth. All aneurysms bore full neointimal linings on the coil mass in the chronic phase. CONCLUSIONS: Vascular occlusion by PVA polymer coil proved superior in normal renal segmental arteries and feasible in surgically constructed carotid aneurysms (with packing densities ≥ 30%), constituting acceptable radiologic feasibility and histologic response.

An analysis of the effects of osmotic backwashing on the seawater reverse osmosis process.

Fouling control is an important consideration in the design and operation of membrane-based water treatment processes. It has been generally known that chemical cleaning is still the most common method to remove foultants and maintain the performance of reverse osmosis (RO) desalination. Regardless of the chemical membrane cleaning methods applied effectively, however, frequent chemical cleaning can shorten the membrane life. In addition, it also increases operating and maintenance costs due to the waste chemical disposal. As an alternative, osmotic backwashing can be applied to RO membranes by diluting the concentration polarization (CP) layer. In this study, the effects of osmotic backwashing were analysed under different total dissolved salts (TDSs) and backwashing conditions, and the parameters of the osmotic backwashing were evaluated. The results of the analysis based on the properties of the organic matters found in raw water showed that the cleaning efficiency in respect to the fouling by hydrophilic organic matters was the greatest. Osmotic backwashing was carried out by changing the TDS of the permeate. As a result, the backwashing volume decreased with time due to the CP of the permeate and the backwashing volume. The difference in the osmotic pressure between the raw water and the permeate (Delta pi) also decreased as time passed. It was confirmed that when the temperature of the effluent was high, both the cleaning efficiency and the backwashing volume, which inpours at the same time, increased. When the circulation flow of the effluent was high, both the cleaning efficiency and the backwashing volume increased.

Hemodynamic effects of long-term morphological changes in the human carotid sinus.

Previous investigations of morphology for human carotid artery bifurcation from infancy to young adulthood found substantial growth of the internal carotid artery with advancing age, and the development of the carotid sinus at the root of the internal carotid artery during teenage years. Although the reasons for the appearance of the carotid sinus are not clearly understood yet, it has been hypothesized that the dilation of the carotid sinus serves to support pressure sensing, and slows the blood flow to reduce pulsatility to protect the brain. In order to understand this interesting evolvement at the carotid bifurcation in the aspects of fluid mechanics, we performed in vitro phase-contrast MR flow experiments using compliant silicone replicas of age-dependent carotid artery bifurcations. The silicone models in childhood, adolescence, and adulthood were fabricated using a rapid prototyping technique, and incorporated with a bench-top flow mock circulation loop using a computer-controlled piston pump. The results of the in vitro flow study showed highly complex flow characteristics at the bifurcation in all age-dependent models. However, the highest magnitude of kinetic energy was found at the internal carotid artery in the child model. The high kinetic energy in the internal carotid artery during childhood might be one of the local hemodynamic forces that initiate morphological long-term development of the carotid sinus in the human carotid bifurcation.

Drug perfusion enhancement in tissue model by steady streaming induced by oscillating microbubbles.

Drug delivery into neurological tissue is challenging because of the low tissue permeability. Ultrasound incorporating microbubbles has been applied to enhance drug delivery into these tissues, but the effects of a streaming flow by microbubble oscillation on drug perfusion have not been elucidated. In order to clarify the physical effects of steady streaming on drug delivery, an experimental study on dye perfusion into a tissue model was performed using microbubbles excited by acoustic waves. The surface concentration and penetration length of the drug were increased by 12% and 13%, respectively, with streaming flow. The mass of dye perfused into a tissue phantom for 30s was increased by about 20% in the phantom with oscillating bubbles. A computational model that considers fluid structure interaction for streaming flow fields induced by oscillating bubbles was developed, and mass transfer of the drug into the porous tissue model was analyzed. The computed flow fields agreed with the theoretical solutions, and the dye concentration distribution in the tissue agreed well with the experimental data. The computational results showed that steady streaming with a streaming velocity of a few millimeters per second promotes mass transfer into a tissue.

Computational study of particle size effects on selective binding of nanoparticles in arterial stenosis.

In order to elucidate particle size and wall shear effects on the selective binding of nanoparticles to vessel wall, particle binding to the wall of arterial stenosis was computationally analyzed using a transport and reaction model. The attachment rate constant was modeled as a function of shear rate and particle size. The results showed that it had a positive correlation with the shear rate for particles smaller than 600 nm and a negative correlation with the shear rate for particles larger than 800 nm. Small size particles showed high binding selectivity in the stenosis region for the normal and shear-activated wall, whereas large particles showed high binding selectivity in the low and oscillatory zone for the shear-activated wall.

Effects of framing coil shape, orientation, and thickness on intra-aneurysmal flow.

To study the effects of the geometrical characteristics of a framing coil on aneurysm thromboembolization efficacy, the hemodynamics in lateral aneurysms filled with coils having a different shape, orientation, and thickness were analyzed using computational fluid dynamics. The aneurysms packed with vortex and cage-shaped coils were modeled using three different coil orientations: transverse, parallel, and orthogonal. The orthogonal orientation of a vortex coil and parallel orientation of a cage-shaped coil showed higher inflow, vorticity, and wall shear stress in the dome region, which provide an unfavorable hemodynamic environment for thromboembolization. Thicker coils also produced unfavorable hemodynamic conditions compared to normal coils having the same shape, orientation, and total coil volume. Though the effects of coil shape and orientation on the hemodynamic parameters of interest were not consistent, the open area at the distal half of the mid-transverse plane of an aneurysm showed significant positive correlation with flow into the dome region and mean vorticity in the dome region. Therefore, blocking the distal mid-transverse plane of an aneurysm using coils would effectively reduce the intra-aneurysmal flow activity and provide a more efficient hemodynamic environment for thromboembolization.

Hemodynamics of cerebral aneurysms: computational analyses of aneurysm progress and treatment.

The progression of a cerebral aneurysm involves degenerative arterial wall remodeling. Various hemodynamic parameters are suspected to be major mechanical factors related to the genesis and progression of vascular diseases. Flow alterations caused by the insertion of coils and stents for interventional aneurysm treatment may affect the aneurysm embolization process. Therefore, knowledge of hemodynamic parameters may provide physicians with an advanced understanding of aneurysm progression and rupture, as well as the effectiveness of endovascular treatments. Progress in medical imaging and information technology has enabled the prediction of flow fields in the patient-specific blood vessels using computational analysis. In this paper, recent computational hemodynamic studies on cerebral aneurysm initiation, progress, and rupture are reviewed. State-of-the-art computational aneurysmal flow analyses after coiling and stenting are also summarized. We expect the computational analysis of hemodynamics in cerebral aneurysms to provide valuable information for planning and follow-up decisions for treatment.