Arterial Vascular Tree Research Articles

A mesh-based model of liver vasculature: implications for improved radiation dosimetry to liver parenchyma for radiopharmaceuticals

PurposeTo develop a model of the internal vasculature of the adult liver and demonstrate its application to the differentiation of radiopharmaceutical decay sites within liver parenchyma from those within organ blood.MethodComputer-generated models of hepatic arterial (HA), hepatic venous (HV), and hepatic portal venous (HPV) vascular trees were algorithmically created within individual lobes of the ICRP adult female and male livers (AFL/AML). For each iteration of the algorithm, pressure, blood flow, and vessel radii within each tree were updated as each new vessel was created and connected to a viable bifurcation site. The vascular networks created inside the AFL/AML were then tetrahedralized for coupling to the PHITS radiation transport code. Specific absorbed fractions (SAF) were computed for monoenergetic alpha particles, electrons, positrons, and photons. Dual-region liver models of the AFL/AML were proposed, and particle-specific SAF values were computed assuming radionuclide decays in blood within two locations: (1) sites within explicitly modeled hepatic vessels, and (2) sites within the hepatic blood pool residing outside these vessels to include the capillaries and blood sinuses. S values for 22 and 10 radionuclides commonly used in radiopharmaceutical therapy and imaging, respectively, were computed using the dual-region liver models and compared to those obtained in the existing single-region liver model.ResultsLiver models with virtual vasculatures of ~ 6000 non-intersecting straight cylinders representing the HA, HPV, and HV circulations were created for the ICRP reference. For alpha emitters and for beta and auger-electron emitters, S values using the single-region models were approximately 11% (AML) to 14% (AFL) and 11% (AML) to 13% (AFL) higher than the S values obtained using the dual-region models, respectively.ConclusionsThe methodology employed in this study has shown improvements in organ parenchymal dosimetry through explicit consideration of blood self-dose for alpha particles (all energies) and for electrons at energies below ~ 100 keV.

Upper limb anatomy and preoperative mapping.

Vascular access is absolutely essential for haemodialysis due to its relationship with quality of dialysis and associated morbidity. Therefore, it must be monitored and continuously surveilled from the moment it is created to prevent failure in maturation and thrombosis. Multidisciplinary collaboration is necessary when the main aim is to achieve the adequate vascular access flow with the fewest possible complications. The starting point, and probably the main one, is vascular access planning. This planning requires both a deep understanding of the anatomy of the upper limb and enough skill to examine it by Doppler ultrasound. The aim of this article is to review the anatomical and haemodynamical concepts of the arterial and venous vascular tree and explain how to perform ultrasound mapping, optimising the technical resources provided by this tool. Likewise, adequate access creation criteria that minimise the risk of failure and associated complications will be discussed.

Modelling physiology of haemodynamic adaptation in short-term microgravity exposure and orthostatic stress on Earth

Cardiovascular haemodynamics alters during posture changes and exposure to microgravity. Vascular auto-remodelling observed in subjects living in space environment causes them orthostatic intolerance when they return on Earth. In this study we modelled the human haemodynamics with focus on head and neck exposed to different hydrostatic pressures in supine, upright (head-up tilt), head-down tilt position, and microgravity environment by using a well-developed 1D-0D haemodynamic model. The model consists of two parts that simulates the arterial (1D) and brain-venous (0D) vascular tree. The cardiovascular system is built as a network of hydraulic resistances and capacitances to properly model physiological parameters like total peripheral resistance, and to calculate vascular pressure and the related flow rate at any branch of the tree. The model calculated 30.0 mmHg (30%), 7.1 mmHg (78%), 1.7 mmHg (38%) reduction in mean blood pressure, intracranial pressure and central venous pressure after posture change from supine to upright, respectively. The modelled brain drainage outflow percentage from internal jugular veins is 67% and 26% for supine and upright posture, while for head-down tilt and microgravity is 65% and 72%, respectively. The model confirmed the role of peripheral veins in regional blood redistribution during posture change from supine to upright and microgravity environment as hypothesized in literature. The model is able to reproduce the known haemodynamic effects of hydraulic pressure change and weightlessness. It also provides a virtual laboratory to examine the consequence of a wide range of orthostatic stresses on human haemodynamics.

Mechanical forces and metabolic changes cooperate to drive cellular memory and endothelial phenotypes.

Endothelial cells line the innermost layer of arterial, venous, and lymphatic vascular tree and accordingly are subject to hemodynamic, stretch, and stiffness mechanical forces. Normally quiescent, endothelial cells have a hemodynamic set point and become "activated" in response to disturbed hemodynamics, which may signal impending nutrient or gas depletion. Endothelial cells in the majority of tissue beds are normally inactivated and maintain vessel barrier functions, are anti-inflammatory, anti-coagulant, and anti-thrombotic. However, under aberrant mechanical forces, endothelial signaling transforms in response, resulting cellular changes that herald pathological diseases. Endothelial cell metabolism is now recognized as the primary intermediate pathway that undergirds cellular transformation. In this review, we discuss the various mechanical forces endothelial cells sense in the large vessels, microvasculature, and lymphatics, and how changes in environmental mechanical forces result in changes in metabolism, which ultimately influence cell physiology, cellular memory, and ultimately disease initiation and progression.

Towards blood flow in the virtual human: efficient self-coupling of HemeLB.

Many scientific and medical researchers are working towards the creation of a virtual human—a personalized digital copy of an individual—that will assist in a patient’s diagnosis, treatment and recovery. The complex nature of living systems means that the development of this remains a major challenge. We describe progress in enabling the HemeLB lattice Boltzmann code to simulate 3D macroscopic blood flow on a full human scale. Significant developments in memory management and load balancing allow near linear scaling performance of the code on hundreds of thousands of computer cores. Integral to the construction of a virtual human, we also outline the implementation of a self-coupling strategy for HemeLB. This allows simultaneous simulation of arterial and venous vascular trees based on human-specific geometries.

Vascular Decoupling in Septic Shock: The Combined Role of Autonomic Nervous System, Arterial Stiffness, and Peripheral Vascular Tone.

BackgroundAcute inflammation and sepsis are known to induce changes in vascular properties, leading to increased arterial stiffness; at the same time, the autonomic nervous system (ANS) also affects vascular properties by modulating the arterial smooth muscle tone, and it is widely reported that sepsis and septic shock severely impair ANS activity. Currently, clinical guidelines are mainly concerned to resuscitate septic shock patients from hypotension, hypovolemia, and hypoperfusion; however, if the current resuscitation maneuvers have a beneficial effect also on vascular properties and autonomic functionality is still unclear. The objective of this work is to assess the effects of standard resuscitation at vascular level and to verify if there is any association between alterations in vascular properties and ANS activity.MethodsSix pigs underwent a protocol of polymicrobial septic shock and resuscitation (fluids and noradrenaline). The arterial blood pressure (ABP) waveform was recorded in the central aorta and in the peripheral radial and femoral artery. The characteristic arterial time constant was computed at the three arterial sites based on the two-element Windkessel model, to characterize the overall arterial vascular tree. Moreover, independent estimates of total arterial compliance (AC) and total peripheral resistance (TPR) were performed. Baroreflex sensitivity (BRS), low frequency (LF, 0.04–0.15 Hz) spectral power of diastolic blood pressure, and indices of heart rate variability (HRV) were computed to assess ANS functionality.ResultsSeptic shock induced a severe vascular disarray, decoupling the usual pressure wave propagation from central to peripheral sites; this phenomenon appeared as an inversion of the physiological pulse pressure (PP) amplification, with a higher PP in the central aorta than in the peripheral arteries. The time constant was decreased, together with AC and TPR. ANS dysfunction was described by a reduced BRS, decreased LF power, and suppressed HRV. This compromised condition was not resolved by administration of fluids and noradrenaline. Thus, a persistent vascular and autonomic dysfunction were reported also in the resuscitated animals, and they were found to be significantly correlated.ConclusionMeasures of vascular function and ANS activity could add information to standard hemodynamic and clinical markers, and the current resuscitation strategies could benefit from the adjunction of these additional functional indices.

Peripheral arterial occlusive disease as predictor of high atherosclerotic burden

Atherosclerosis is a disease which affects the whole arterial vascular tree. In particular patients with peripheral arterial occlusive disease (PAOD) often suffer from additional atherosclerotic manifestations in other vascular territories. This has adirect impact on cardiovascular prognosis. Atherosclerosis is an inflammatory disease. A high inflammatory burden is associated with polyvascular atherosclerosis and also with the occurrence of cardiovascular events. Control of cardiovascular risk factors is crucial for the treatment of patients with polyvascular atherosclerosis. In addition, anticoagulation treatment is very important in patients with atherosclerosis. Moreover, exercise training is an important treatment option in PAOD patients not only to improve walking distance but also for multiple additional positive effects. So far the role of anti-inflammatory treatment is not clear and must be further elaborated by future clinical research.

Vascular anomalies. PartI: vascular tumors

Vascular anomalies represent aspectrum of structural disorders and inborn errors of vascular morphogenesis, which may affect the entire arterial and venous vascular tree. They are divided into two major categories: tumors, which exhibit endothelial hyperplasia and malformations, which have normal endothelial turnover unless disturbed. Depending on their nature and complexity they can range from asimple "birthmark" to life-threatening entities. The relatively low incidence (4-10%) of vascular anomalies among the general population combined with the fact that their management often falls within the purview of several different medical and surgical specialties, has traditionally resulted in insufficient expertise in the management of these conditions. Therefore, accurate identification, a uniform nomenclature and a multidisciplinary approach are paramount for correct management.

Multiple coupled resonances in the human vascular tree: refining the Westerhof model of the arterial system.

The human arterial vascular tree can be described by multicompartment models using electrical components. First introduced in the 1960s by Noordergraaf and Westerhof, these hardware-based approaches required several simplifications. We were able to remove the restrictions using modern software simulation tools and improve overall model quality considerably. Whereas the original Westerhof model consisted of 121 Windkessel elements, the refined model has 711 elements and gives realistic pulse waveforms of the aorta and brachial and radial arteries with realistic blood pressures. Moreover, novel insights concerning the formation of the physiological aortic-to-radial transfer function were gained. Its being potentially due to the coupling of many small resonant elements gives new impetus to the discussion of arterial pressure wave reflection. The individualized transfer function derived from our improved model incorporates distinct patient characteristics and can potentially be used for estimation of central blood pressure values. NEW & NOTEWORTHY We were able to find an individualized transfer function giving realistic pulse waveforms and blood pressures using a multicompartment model of the arterial system. Based on the hardware-built Westerhof approach, several simplifications initially introduced in the 1960s could be reversed using software simulation. Overall model quality was improved considerably, and multiple coupled resonances were identified as potential explanation for the formation of the aortic-to-radial transfer function, giving new impetus to the discussion of arterial pressure wave reflection.

Pulmonary vasculature in dogs assessed by three-dimensional fractal analysis and chemometrics.

Fractal analysis of canine pulmonary vessels could allow quantification of their space-filling properties. Aims of this prospective, analytical, cross-sectional study were to describe methods for reconstructing three dimensional pulmonary arterial vascular trees from computed tomographic pulmonary angiogram, applying fractal analyses of these vascular trees in dogs with and without diseases that are known to predispose to thromboembolism, and testing the hypothesis that diseased dogs would have a different fractal dimension than healthy dogs. A total of 34 dogs were sampled. Based on computed tomographic pulmonary angiograms findings, dogs were divided in three groups: diseased with pulmonary thromboembolism (n=7), diseased but without pulmonary thromboembolism (n=21), and healthy (n=6). An observer who was aware of group status created three-dimensional pulmonary artery vascular trees for each dog using a semiautomated segmentation technique. Vascular three-dimensional reconstructions were then evaluated using fractal analysis. Fractal dimensions were analyzed, by group, using analysis of variance and principal component analysis. Fractal dimensions were significantly different among the three groups taken together (P=0.001), but not between the diseased dogs alone (P=0.203). The principal component analysis showed a tendency of separation between healthy control and diseased groups, but not between groups of dogs with and without pulmonary thromboembolism. Findings indicated that computed tomographic pulmonary angiogram images can be used to reconstruct three-dimensional pulmonary arterial vascular trees in dogs and that fractal analysis of these three-dimensional vascular trees is a feasible method for quantifying the spatial relationships of pulmonary arteries. These methods could be applied in further research studies on pulmonary and vascular diseases in dogs.

Noninvasive Assessment of the Effect of Position and Exercise on Pulse Arrival to Peripheral Vascular Beds in Healthy Volunteers.

Background: The effects of position and exercise on pulse wave distribution across a healthy, compliant arterial tree are not fully understood. We studied the effects of exercise and position on the pattern of pulse arrival times (PATs) in healthy volunteers. Moreover, we compared the pulse arrival time ratios to the respective distance ratios between different locations.Methods: Thirteen young healthy volunteers were studied, using an electrocardiogram and plethysmograph to simultaneously record pulse wave arrival at the ear lobe, index finger and big toe. We compared the differences in PAT between each location at rest and post-exercise in the supine, sitting, and standing position. We also compared the PAT ratio (toe/ear, toe/finger, and finger/ear) to the corresponding pulse path distance ratios.Results: PAT was shortest at the ear then finger and longest at the toe regardless of position or exercise status. PATs were shorter post-exercise compared to rest. When transitioning from a standing to sitting or supine position, PAT to the ear decreased, while the PAT to the toe increased, and PAT to the finger didn't significantly change. PAT ratios were significantly smaller than predicted by the path distance ratios regardless of position or exercise status.Conclusions: Exercise makes PATs shorter. Standing position decrease PAT to the toe and increase to the ear. We conclude that PAT and PAT ratio represent the arterial vascular tree properties as surely as pulse transit time and pulse wave velocity.

Analysis of a Model for the Morphological Structure of Renal Arterial Tree: Fractal Structure

One of the fields of applied mathematics is related to model analysis. Biomedical systems are suitable candidates for this field because of their importance in life sciences including therapeutics. Here we deal with the analysis of a model recently proposed by Espinoza-Valdez et al. (2010) for the kidney vasculature developed via angiogenesis. The graph theory allows one to model quantitatively a vascular arterial tree of the kidney in sense that (1) the vertex represents a vessels bifurcation, whereas (2) each edge stands for a vessel including physiological parameters. The analytical model is based on the two processes of sprouting and splitting angiogeneses, the concentration of the vascular endothelial growth factor (VEGF), and the experimental data measurements of the rat kidneys. The fractal dimension depends on the probability of sprouting angiogenesis in the development of the arterial vascular tree of the kidney, that is, of the distribution of blood vessels in the morphology generated by the analytical model. The fractal dimension might determine whether a suitable renal vascular structure is capable of performing physiological functions under appropriate conditions. The analysis can describe the complex structures of the development vasculature in kidney.

Flow and anastomosis in vascular networks

We analyze the effect that the geometrical place of anastomosis in the circulatory tree has on blood flow. We introduce an idealized model that consists of a symmetric network for the arterial and venous vascular trees. We consider that the network contains a viscoelastic fluid with the rheological characteristics of blood, and analyze the network hydrodynamic response to a time-dependent periodic pressure gradient. This response is a measurement of the resistance to flow: the larger the response, the smaller the resistance to flow. We find that for networks whose vessels have the same radius and length, the outer the level of the branching tree in which anastomosis occurs, the larger the network response. Moreover, when anastomosis is incorporated in the form of bypasses that bridge vessels at different bifurcation levels, the further apart are the levels bridged by the bypass, the larger the response is. Furthermore, we apply the model to the available information for the dog circulatory system and find that the effect that anastomosis causes at different bifurcation levels is strongly determined by the structure of the underlying network without anastomosis. We rationalize our results by introducing two idealized models and approximated analytical expressions that allow us to argue that, to a large extent, the response of the network with anastomosis is determined locally. We have also considered the influence of the myogenic effect. This one has a large quantitative impact on the network response. However, the qualitative behavior of the network response with anastomosis is the same with or without consideration of the myogenic effect. That is, it depends on the structure that the underlying vessel network has in a small neighborhood around the place where anastomosis occurs. This implies that whenever there is an underlying tree-like network in an in vivo vasculature, our model is able to interpret the anastomotic effect.

Integration of the baroreflex control mechanism in a heterogeneous model of the cardiovascular system

The present work describes the mathematical model of the baroreflex receptor mechanism working on a dimensionally‐heterogeneous (1D‐0D) closed‐loop model of the cardiovascular system. Such heterogeneous model includes the 1D description of the arterial tree, 0D model for the venous, pulmonary and cardiac circulation. The detailed description of the arterial vascular tree allow us to perform vasomotor control actions in a different way, while gaining insight about the effects of the baroreflex regulation over hemodynamic quantities of interest throughout the entire vascular system. One example is presented: we simulate the hemorrhage in the abdominal aorta artery and analyze the action of the baroreflex over the system.CAPES, CNPq and FAPERJ

Toward organ printing: Design characteristics, virtual modelling and physical prototyping vascular segments of kidney arterial tree

Organ printing is defined as the layer by layer additive biofabrication of three-dimensional (3D) tissue and organ constructs using tissue spheroids as building blocks. Ultimately, successful bioprinting of human organ constructs is dependent on a ‘built in’ vascular tree to perfuse and maintain the viability of the organ constructs. Thus, the design of the vascular tree is a critically important step in practical implementation of organ printing technology. Bioprinting a vascular tree requires detailed knowledge of the morphometrical, morphological and biomechanical characteristics of the sequentially branched segments of the natural vascular tree as well as insight on post-printing tissue compaction and remodelling. Toward accomplishing this goal, we characterised the morphometrical, morphological and biomechanical characteristics of the initial segments of the natural kidney arterial vascular tree of the porcine kidney. Computer simulation was used to model compaction of tissue engineered tubular vascular segments with different wall thicknesses virtually biofabricated from closely packed and fused uniformly sized vascular tissue spheroids. The number of concentric layers of tissue spheroids required to bioprint tubular vascular segments with desirable wall thickness and diameter was theoretically estimated. Our results demonstrate that vascular segment compaction correlates well with reported experimental data. Finally, physical prototyping of linear and branched tubular constructs using silicon droplets as physical analogues of tissue spheroids was performed. Thus, virtual and physical prototyping provide important insights into the design parameters and demonstrate the principal feasibility of bioprinting a branched vascular tree using vascular tissue spheroids.

Model combining hydrodynamics and fractal theory for analysis of in vivo peripheral pulmonary and systemic resistance of shunt cardiac defects

The fractal state of the arterial vascular tree is considered to have a universal dimension related to the principle of minimum work rate, but can demonstrate the capacity to adapt to other dimensions in disease states such as congenital high-flow pulmonary hypertension (PH) by a process that is incompletely understood. To document and interpret fractal adaptation in patients with different degrees of PH, pulmonary and systemic vascular resistance was analyzed by a model that evaluated the fractal dimension, x, of the Poiseuille resistance contribution of the arterial vessel radius between 10 and 100 μm, via the proportionality Q∝( R peri/ BL) − x/4 , with Q, R peri, and BL clinically observed variables representing total pulmonary or systemic blood flow, its peripheral arterial resistance, and body length, respectively. Identification of x in the pulmonary (P) and systemic (S) beds was evaluated from hemodynamic data of 213 patients, categorized into 7 groups by PH grade. In controls without PH, x P=2.2 while the dimension increased to 3.0, with the systemic dimension constant at x S=3.1. Our model predicts that severe grades of PH are associated with: a more elongated and hindered vessel in the periphery, and reductions in vessel numbers, as unit pulmonary resistive arterial trees ( N 1) and their component intra-acinar arteries ( N W). These model network changes suggest a complex adaptive process of arterial network reorganization in the pulmonary circulation to minimize the work rate of high-flow congenital heart defects.

A model for renal arterial branching based on graph theory

The kidney is one of the most complicated organs in terms of structure and physiology, in part because it is highly vascularized. The renal vascular development occurs through two mechanisms that sometimes overlap: vasculogenesis and angiogenesis. Here, we consider angiogenesis to model the renal arterial tree with the two processes of vascular angiogenesis: sprouting and splitting. We recognize the vessels are not tubes with ends that get glued but physiological factors are relevant into the vascular development. Our contribution integrates the graph theory and physiological information to derive a quantitative model for the vascular tree in the sense that the vertices and edges represent, respectively, a branching point and a vessel. From such a premise, development of the arterial vascular tree of the kidney is mathematically expressed, including physiological processes as the effect of the vascular endothelial growth factor (VEGF) on the vessel length. A definition of the graph is used to visualize the topology of vascular tree in kidney providing physiological information into the edges. Thus, renal arterial branching is modeled as a graph where edges are labeled and oriented.

Cytochromes CYP1A1 and CYP1B1: new pieces in the puzzle to understand the biomechanical paradigm of atherosclerosis

Atherosclerosis is epidemiologically linked and causally related to the presence of ‘risk factors’. Despite their diversity, major risk factors for cardiovascular disease such as hypercholesterolaemia, diabetes, hypertension, physical inactivity, obesity, and tobacco smoking share a common ‘systemic’ mechanism of action, i.e. they act on the entire inner surface of the arterial vascular tree. The cellular and molecular effects of such systemic risk factors, acting through biohumoral mediators, can account for the greater or lesser propensity of different individuals to atherosclerotic vascular disease (the ‘biohumoral’ paradigm).1,2 Atherosclerosis is, however, focal and discrete in location and has clear preferences for certain sites of the vasculature, such as branching points, bifurcations, or the convex side of curved arteries. In addition, some arteries are more prone to atherosclerosis than others (e.g. the carotid artery vs. the subclavian artery, epicardial coronary arteries vs. intramyocardial arteries), and there are preferential locations even within extremely close areas in the same artery, such as in the region of the carotid bifurcation. The ‘site-specific’ location of the process is a golden opportunity, and perhaps a ‘Holy Grail’ for atherosclerosis research. It is usually explained by the action of particular types of shear stress imposed on the arterial wall by flow regimens of the circulating blood.3 In recent years, much progress has been gained in understanding how shear stress is transduced within the artery wall in order to protect from or promote atherogenesis (the ‘biomechanical’ paradigm). Crucial to this understanding is the identification of endothelial responses to shear stress, by which endothelial cells can sense and integrate haemodynamic stimuli and react to them. The arterial endothelium is exposed to three main varieties of haemodynamic forces:4,5 (a) the pressure generated by hydrostatic forces towards the vessel wall; (b) circumferential tensions or stress, resulting from … *Corresponding author. Tel: +39 0871 415 12; fax: +39 0871 402 817. E-mail : rdecater{at}unich.it

64-MDCT imaging of the coronary arteries and systemic arterial vascular tree in a single examination: optimisation of the scan protocol and contrast-agent administration

The aim of this study was to validate a 64-row multidetector computed tomography (64-MDCT) acquisition protocol with biphasic administration of contrast medium for comprehensive assessment of the coronary and systemic arterial tree in a single examination. The scanning protocol comprised two acquisitions: an electrocardiograph (ECG)-gated scan at the level of the heart, followed by a total-body, low-dose scan of the systemic arterial circulation. Twenty patients were evaluated using two different strategies for contrast administration. In ten patients, the delay between the two acquisitions was set at 40 s, whereas in the remaining patients, it varied between 45 s and 65 s. For both strategies, the degree of systemic arterial opacification and the attenuation gradient between arterial and venous structures were quantitatively assessed at six extracoronary locations. Two observers evaluated in consensus the presence or absence of atherosclerosis and the degree of stenosis of arterial segments. Three hundred coronary segments were analysed. Arterial-wall changes were depicted in 155 (51%) segments, and in 35 (23%), the degree of stenosis was > 50%. Of the 640 extracoronary arterial segments, 250 (39%) presented atherosclerotic wall alterations, in 50 (20%), the degree of stenosis was > 50% and five were affected by aneurysmal dilatation. The magnitude of arterial opacification values and attenuation gradients between arterial and venous structures were significantly higher in patients scanned with the 40-s fixed-delay strategy. Whole-body CT angiography with biphasic administration of contrast agent and fixed scan delay has been shown to be a feasible and reproducible technique. Comprehensive data on the global atherosclerotic burden potentially offer important therapeutic options for subclinical, high-risk segments.

Gefäßkorrosionspräparate der Lendenwirbelsäule - Technik - Ergebnisse - Anwendung

The present paper reports on the preparation of vascular corrosion specimens of the lumbar spine, which permit Three-dimensional representation of the arterial and venous vascular tree. The technique, which uses stained methacrylate, is described and the results are illustrated in several figures. Applications include analysis of surgical approaches and the chances of success, e.g., of spondylodeses.