Embolus Analog Trajectory Paths Under Physiological Flowrates Through Patient-Specific Aortic Arch Models

F Malone; E McCarthy; P Delassus; J H Buhk; J Fiehler; L Morris

doi:10.1115/1.4043832

Embolus Analog Trajectory Paths Under Physiological Flowrates Through Patient-Specific Aortic Arch Models

J Biomech Eng. 2019 Oct 1;141(10):101007. doi: 10.1115/1.4043832.

Authors

F Malone¹, E McCarthy², P Delassus², J H Buhk³, J Fiehler³, L Morris⁴

Affiliations

¹ GMedTech,Department of Mechanical andIndustrial Engineering,Galway-Mayo Institute of Technology,Galway H91 T8NW, Irelande-mail: fiona.malone@gmit.ie.
² GMedTech,Department of Mechanical andIndustrial Engineering,Galway-Mayo Institute of Technology,Galway H91 T8NW, Ireland.
³ Department of Diagnostic andInterventional Neuroradiology,University Medical Center Hamburg-Eppendorf,Martinistr. 52,Hamburg 20246, Germany.
⁴ GMedTech,Department of Mechanical andIndustrial Engineering,Galway-Mayo Institute of Technology,Galway H91 T8NW, Irelande-mail: liam.morris@gmit.ie.

PMID: 31116368
DOI: 10.1115/1.4043832

Abstract

Atrial fibrillation (AF) is the most common irregular heartbeat among the world's population and is a major contributor to cardiogenic embolisms and acute ischemic stroke (AIS). However, the role AF flow plays in the trajectory paths of cardiogenic emboli has not been experimentally investigated. A physiological simulation system was designed to analyze the trajectory patterns of bovine embolus analogs (EAs) (n = 720) through four patient-specific models, under three flow conditions: steady flow, normal pulsatile flow, and AF pulsatile flow. It was seen that EA trajectory paths were proportional to the percentage flowrate split of 25-31% along the branching vessels. Overall, AF flow conditions increased trajectories through the left- (LCCA) and right (RCCA)-common carotid artery by 25% with respect to normal pulsatile flow. There was no statistical difference in the distribution of clot trajectories when the clot was released from the right, left, or anterior positions. Significantly, more EAs traveled through the brachiocephalic trunk (BCT) than through the LCCA or the left subclavian. Yet of the EAs that traveled through the common carotid arteries, there was a greater affiliation toward the LCCA compared to the RCCA (p < 0.05).

Keywords: acute ischemic stroke; aortic arch; atrial fibrillation; cardiogenic emboli; physiological simulation.