title: Magnetic resonance imaging-based computational modelling of blood flow and nanomedicine deposition in patients with peripheral arterial disease.
abstract: Peripheral arterial disease (PAD) is generally attributed to the progressive vascular accumulation of lipoproteins and circulating monocytes in the vessel walls leading to the formation of atherosclerotic plaques. This is known to be regulated by the local vascular geometry, haemodynamics and biophysical conditions. Here, an isogeometric analysis framework is proposed to analyse the blood flow and vascular deposition of circulating nanoparticles (NPs) into the superficial femoral artery (SFA) of a PAD patient. The local geometry of the blood vessel and the haemodynamic conditions are derived from magnetic resonance imaging (MRI), performed at baseline and at 24 months post intervention. A dramatic improvement in blood flow dynamics is observed post intervention. A 500% increase in peak flow rate is measured in vivo as a consequence of luminal enlargement. Furthermore, blood flow simulations reveal a 32% drop in the mean oscillatory shear index, indicating reduced disturbed flow post intervention. The same patient information (vascular geometry and blood flow) is used to predict in silico in a simulation of the vascular deposition of systemically injected nanomedicines. NPs, targeted to inflammatory vascular molecules including VCAM-1, E-selectin and ICAM-1, are predicted to preferentially accumulate near the stenosis in the baseline configuration, with VCAM-1 providing the highest accumulation (approx. 1.33 and 1.50 times higher concentration than that of ICAM-1 and E-selectin, respectively). Such selective deposition of NPs within the stenosis could be effectively used for the detection and treatment of plaques forming in the SFA. The presented MRI-based computational protocol can be used to analyse data from clinical trials to explore possible correlations between haemodynamics and disease progression in PAD patients, and potentially predict disease occurrence as well as the outcome of an intervention.
authors: Department of Translational Imaging, Houston Methodist Hospital Research Institute, Houston, TX, USA Department of Nanomedicine, Houston Methodist Hospital Research Institute, Houston, TX, USA shossain@texasheart.org.
authors: Shaolie S
authors: SS
authors: Hossain
authors: Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
authors: Yongjie
authors: Y
authors: Zhang
authors: Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
authors: Xiaoyi
authors: X
authors: Fu
authors: Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital Research Institute, Houston, TX, USA Division of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors: Gerd
authors: G
authors: Brunner
authors: Department of Translational Imaging, Houston Methodist Hospital Research Institute, Houston, TX, USA Department of Nanomedicine, Houston Methodist Hospital Research Institute, Houston, TX, USA.
authors: Jaykrishna
authors: J
authors: Singh
authors: Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX, USA.
authors: Thomas J R
authors: TJ
authors: Hughes
authors: Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital Research Institute, Houston, TX, USA.
authors: Dipan
authors: D
authors: Shah
authors: Department of Translational Imaging, Houston Methodist Hospital Research Institute, Houston, TX, USA Department of Nanomedicine, Houston Methodist Hospital Research Institute, Houston, TX, USA pdecuzzi@houstonmethodist.org.
authors: Paolo
authors: P
authors: Decuzzi
mesh_terms: D065966:Absorption, Physicochemical; D001158:Arteries / Q000737:chemistry* / Q000473:pathology / Q000503:physiopathology*; D050197:Atherosclerosis / Q000188:drug therapy / Q000503:physiopathology*; D001783:Blood Flow Velocity; D003198:Computer Simulation; D016903:Drug Monitoring / Q000379:methods; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008955:Models, Cardiovascular; D053758:Nanoparticles / Q000008:administration & dosage / Q000737:chemistry*; D016896:Treatment Outcome
keywords: atherosclerosis; finite-element modelling; magnetic resonance imaging; nanoparticles; vascular adhesion