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Computers in Biology and Medicine Sep 2021Coronary artery disease (CAD) is the leading cause of death in the United States (US) and a major contributor to healthcare cost. Accurate segmentation of coronary...
BACKGROUND
Coronary artery disease (CAD) is the leading cause of death in the United States (US) and a major contributor to healthcare cost. Accurate segmentation of coronary arteries and detection of stenosis from invasive coronary angiography (ICA) are crucial in clinical decision making.
PURPOSE
We aim to develop an automatic method to extract coronary arteries by deep learning and detect arterial stenosis from ICAs.
METHODS
In this study, a deep learning model which integrates a feature pyramid with a U-Net++ model was developed to automatically segment coronary arteries in ICAs. A compound loss function which contains Dice loss, dilated Dice loss, and L2 regularization was utilized to train the proposed segmentation model. Following the segmentation, an algorithm which extracts vascular centerlines, calculates the diameters, and measures the stenotic levels, was developed to detect arterial stenosis.
RESULTS AND CONCLUSIONS
In the dataset consisting of 314 ICAs obtained from 99 patients, the segmentation model achieved an average Dice score of 0.8899, a sensitivity of 0.8595, and a specificity of 0.9960. In addition, the stenosis detection algorithm achieved a true positive rate of 0.6840 and a positive predictive value of 0.6998 on all types of stenosis, which has great promise to advance to clinical uses and could provide auxiliary suggestions for CAD diagnosis and treatment.
Topics: Constriction, Pathologic; Coronary Angiography; Coronary Vessels; Humans
PubMed: 34315031
DOI: 10.1016/j.compbiomed.2021.104667 -
Kyobu Geka. the Japanese Journal of... Sep 2019The important point in vascular anastomosis is anastomosis with a secure suture and prevention of thrombosis. Uncertainty in sutures can cause bleeding from the...
The important point in vascular anastomosis is anastomosis with a secure suture and prevention of thrombosis. Uncertainty in sutures can cause bleeding from the anastomotic site and post operative pseudoaneurysm formation. In addition, the failure of the antithrombotic function causes early occlusion of the anastomotic site due to thrombus formation, causing intimal thickening and causing stenosis of the anastomotic site. Vascular anastomosis must be performed with attention to the property and site of the blood vessel, the method of graft formation, and the procedure of suturing. Training is required for fast and accurate sutures, and it is also important to conduct off the job training to efficiently improve your proficiency.
Topics: Anastomosis, Surgical; Arteries; Constriction, Pathologic; Humans; Suture Techniques; Sutures; Vascular Surgical Procedures
PubMed: 31582694
DOI: No ID Found -
Computer Methods and Programs in... Jun 2022Atherosclerosis is a leading cause of potentially serious cardiovascular diseases such as heart attack, stroke, and peripheral artery disease. Due to the prolonged and...
BACKGROUND AND OBJECTIVE
Atherosclerosis is a leading cause of potentially serious cardiovascular diseases such as heart attack, stroke, and peripheral artery disease. Due to the prolonged and non-reversible process of thickening arteries walls, atherosclerosis plaques in the blood vessels are formed that restrict the blood flow. Early detection plays a vital role in minimizing the risk as there is no reliable method to detect the early stage of the disease. This paper proposes a novel atherosclerosis detection method based on the emerging paradigm of molecular communications. The work could pave the way to implement a low-cost and straightforward early detection method of atherosclerosis in the future.
METHODS
We used COMSOL to model the physical field, coupled the fluid module and the fluid particle tracking module, and mapped the contrast agent into nanoparticles (NPs). The NPs are released at the entrance of the blood vessel and received at the exit of the blood vessel, while NPs are propagating through different arterial stenosis. The arrival probability of NPs is defined as the ratio of the number of NPs that reach the outlet to the total number of released NPs. As a result of atherosclerosis, the arrival probability of Nps is affected by the dynamic flow nature changes, thereby reflecting the arterial stenosis degree. Furthermore, we introduce the multi-release method in this study, which has a similar concept of Inter-symbol interference in traditional communication. This multi-release method leads the overlapping concentrations of NPs remaining in the vessels and enhances the differences of arrival probability in different degrees of stenosis, which increases the chance of more observable results.
RESULTS
The assessment of arterial stenosis degree can be from the early stage to the late stage of the disease. To evaluate the arterial stenosis degree, we analyzed the Poincaré maps, representing the arrival probability of NPs at different arterial stenosis. Moreover, we could directly use data to quantify the pathological process at various stages. The difference between the data results obtained through multiple release methods is more prominent than a single-released method.
CONCLUSIONS
This research proposes a new atherosclerosis detection method based on molecular communication, that is, to evaluate the arterial stenosis degree by modelling and using statistical data of NPs emission and reception in blood vessels. This method can not only use a simple method to detect the early stage of the disease. In addition, we can directly use data to quantify the pathological process of each stage, which is straightforward to assist doctors and may reduce the labour cost of traditional detection.
Topics: Arteries; Atherosclerosis; Communication; Constriction, Pathologic; Hemodynamics; Humans
PubMed: 35320741
DOI: 10.1016/j.cmpb.2022.106756 -
Contrast Media & Molecular Imaging 2022In order to explore the risk factors of intracranial and intracranial arterial stenosis, the distribution of young ischemic stroke sufferers with intracranial and...
In order to explore the risk factors of intracranial and intracranial arterial stenosis, the distribution of young ischemic stroke sufferers with intracranial and intracranial arterial stenosis and the related are analyzed. In this study, a total of 213 young sufferers with ischemic stroke (IS) admitted to our hospital from February 2019 to September 2021 are selected. According to the CT diagnosis of intracranial artery stenosis (AS), 213 patients are divided into two groups, with 86 in the AS Group and 127 in the non-AS Group. To analyze the distribution of intracranial and intracranial AS in young patients with ischemic stroke, 86 patients with AS are examined by carotid B-mode ultrasound. Furthermore, a univariate analysis is performed on the relevant indicators of the sufferers in the cancer (CA) set and the two sets without CA, and then, the indicators with statistically extensive disparity were selected for multivariate logistic regression analysis of the risk factors for CA symptoms. The results show 50% of the sufferers with moderate or severe ischemic CA in young adults and 63.95% of the sufferers with intracranial artery stenosis. It is clearly evident that the main risk factors affecting the occurrence of intracranial and intracranial arteries in young IS are hypertension and long-term smoking, long-term drinking, and hyperlipidemia.
Topics: Arteries; Constriction, Pathologic; Humans; Ischemic Stroke; Risk Factors; Stroke; Young Adult
PubMed: 35845727
DOI: 10.1155/2022/9684158 -
Annals of Biomedical Engineering Jun 2023In order to study the influence of different vascular stenosis rates and stent-to-artery ratios on the fatigue strength and reliability of lower limb arterial stents,... (Review)
Review
In order to study the influence of different vascular stenosis rates and stent-to-artery ratios on the fatigue strength and reliability of lower limb arterial stents, numerical simulation was conducted for the fatigue strength of complete SE stents under pulsating loads using a finite element method. Then, fracture mechanics and conditional probability theory were adopted for mathematical modeling, whereby analyzing the crack growth rate and reliability with stents of different thickness (0.12, 0.15, and 0.18 mm) at different vascular stenosis rates (30, 50, and 70%) and stent-to-artery ratios (80, 85, and 90%). The study found: all three stents of different thickness failed to meet 10-year service life at three vascular stenosis rates; all three stents of different thickness met 10-year service life at three stent-to-artery ratios. With increased vascular stenosis rate, the elastic strain of stents was increased, while the fatigue strength was decreased; with increased stent-to-artery ratio, the elastic strain of the stent was increased, while the reliability of the stent was reduced. After the stent with an initial crack was implanted into the vessel, the crack length underwent non-linear growth with increased pulsating cyclic loads. When the pulsating load reached 3 × 10, the growth rate of the crack on the stent surface increased exponentially, leading to a rapid decrease in reliability. Vascular stenosis rate, stent release ratio, and support thickness have significant effects on crack length propagation rate and reliability. Determining the influence of vascular stenosis rate and stent-to-artery ratio on the fatigue strength and reliability of stents provides a valuable reference for evaluating the fracture failure rate and safety of stents.
Topics: Humans; Constriction, Pathologic; Reproducibility of Results; Stress, Mechanical; Finite Element Analysis; Stents; Arteries; Prosthesis Design
PubMed: 36939956
DOI: 10.1007/s10439-023-03165-6 -
Cardiovascular Revascularization... Mar 2021
Topics: Carotid Arteries; Constriction, Pathologic; Endarterectomy, Carotid; Humans; Stents
PubMed: 33468421
DOI: 10.1016/j.carrev.2021.01.007 -
European Review For Medical and... Nov 2022The relationship between thyroid function and carotid artery stenosis in euthyroid patients is controversial. Therefore, we aimed at evaluating the relationship between...
OBJECTIVE
The relationship between thyroid function and carotid artery stenosis in euthyroid patients is controversial. Therefore, we aimed at evaluating the relationship between the severity of carotid artery disease (CAD) and thyroid-stimulating hormone (TSH) levels in euthyroid patients.
PATIENTS AND METHODS
A total of 90 euthyroid patients with CAD were trichotomized into three groups based on CAD severity. Group 1 comprised patients who had one internal carotid artery with total stenosis and the other with more than 50% stenosis. In Group 2, patients had one internal carotid artery with total stenosis and the other with less than 50% stenosis. Group 3 comprised patients with less than 50% stenosis in both internal carotid arteries. Demographic data, complete blood count, biochemical parameters, and thyroid function parameters were compared between the groups.
RESULTS
No significant relationship was noted between the severity of CAD and demographic data and comorbidity rates. A comparison of the biochemical parameters revealed that TSH levels were significantly different between the groups. Post-hoc analysis showed that Group 1 and Group 3 differed significantly with respect to TSH levels (0.75 ± 0.37 IU/mL vs. 1.39 ± 1.00 IU/mL, p=0.002). A cut-off value of 0.65 yielded 46.67% sensitivity and 81.67% specificity, whereas a cut-off value of 0.70 yielded 53.33% sensitivity and 75.00% specificity. The area under the curve was 0.691 (95% CI, 0.576-0.806) (p=0.003).
CONCLUSIONS
TSH can be demonstrated to predict severe carotid artery disease. Therefore, the severity of CAD can be assessed using TSH levels.
Topics: Humans; Thyrotropin; Constriction, Pathologic; Carotid Artery Diseases; Carotid Artery, Internal; Carotid Stenosis
PubMed: 36459014
DOI: 10.26355/eurrev_202211_30363 -
Journal of Ultrasound in Medicine :... Mar 2018Carotid endarterectomy and carotid artery stenting are among the most common peripheral vascular procedures performed worldwide. Sonography is the initial and often only... (Review)
Review
Carotid endarterectomy and carotid artery stenting are among the most common peripheral vascular procedures performed worldwide. Sonography is the initial and often only imaging modality used in the evaluation of iatrogenic carotid arterial injuries. This pictorial essay provides an overview of the clinical and sonographic findings of complications after interventions in the extracranial carotid arteries, including dissection, fluid collections, pseudoaneurysm, thrombosis, thromboembolism, restenosis, and stent deformation. Grayscale, color, and pulsed Doppler imaging findings are reviewed, and correlations with computed tomography, magnetic resonance imaging, and angiography are provided.
Topics: Carotid Arteries; Carotid Artery Injuries; Carotid Stenosis; Constriction, Pathologic; Endarterectomy, Carotid; Humans; Postoperative Complications; Prosthesis Failure; Stents; Ultrasonography
PubMed: 28877355
DOI: 10.1002/jum.14376 -
Annual International Conference of the... Jul 2020The sound generated by diseased carotid arteries was investigated through computational means using three-dimensional, idealized, stenosed carotid bifurcation models....
The sound generated by diseased carotid arteries was investigated through computational means using three-dimensional, idealized, stenosed carotid bifurcation models. Stenosis levels of 50% and 70% with axi-symmetric and asymmetric stenosis shapes were considered. The hemodynamic flow field was obtained by solving the incompressible, Navier-Stokes equations. The resulting pressure fluctuations at the vessel walls were then used as input for a linearized wave equation for the propagation of vibrations through the modeled surrounding tissue. As observed in prior studies, the sound spectra obtained at the tissue surface indicate a 'break frequency', i.e. a frequency beyond which there is a drop-off in sound spectra intensity. This frequency was found to scale with stenosis diameter and average velocity at the stenosis throat, provided the stenosis shape remained the same. This has important implications on past attempts to estimate stenosis diameter from the break frequency.
Topics: Auscultation; Carotid Arteries; Constriction, Pathologic; Hemodynamics; Humans; Sound
PubMed: 33018553
DOI: 10.1109/EMBC44109.2020.9175422 -
Bio-medical Materials and Engineering 2023Pulmonary artery stenosis is a serious threat to people's life and health.
BACKGROUND
Pulmonary artery stenosis is a serious threat to people's life and health.
OBJECTIVE
The hydrodynamic mechanism of pulmonary artery stenosis is investigated.
METHODS
Numerical analysis of hemodynamics in pulmonary artery stenosis using computational fluid dynamics techniques is performed. An idealized model of pulmonary artery stenosis is established, and the model is divided into main pulmonary artery, right and left pulmonary arteries, and their branches. The sections at different positions are intercepted to study the distribution trend of maximum velocity, pressure and wall shear stress.
RESULTS
The numerical simulation results show that the pressure drop at both ends of the narrow area is large. High velocity and wall shear stress exist in the center of stenosis, and the wall shear stress at the distal end of stenosis gradually decreases, resulting in endothelial dysfunction.
CONCLUSIONS
To some extent, this study helps clinicians make diagnosis and treatment plans in advance and improve prognosis. This method could be used in the numerical simulation of practical models.
Topics: Humans; Stenosis, Pulmonary Artery; Constriction, Pathologic; Models, Cardiovascular; Hemodynamics; Pulmonary Artery; Computer Simulation; Stress, Mechanical; Blood Flow Velocity
PubMed: 36120760
DOI: 10.3233/BME-221418