ARTÍCULO

The role of angled-tip microcatheter and microsphere injection in liver radioembolization: a computational particle-hemodynamics study

Autores: Aramburu Montenegro, Jorge; Antón Remírez, Raúl; Rivas Nieto, Alejandro; Ramos González, Juan Carlos; Sangro Gómez-Acebo, Bruno Carlos; Bilbao Jaureguízar, José Ignacio
Título de la revista: INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING
ISSN: 2040-7939
Páginas: e02895
Fecha de publicación: 2017
Resumen:
Liver radioembolization is a promising treatment option for combating liver tumors. It is performed by placing a microcatheter in the hepatic artery and administering radiation-emitting microspheres through the arterial bloodstream so that they get lodged in the tumoral bed. In avoiding nontarget radiation, the standard practice is to conduct a pretreatment, in which the microcatheter location and injection velocity are decided. However, between pretreatment and actual treatment some of the parameters that influence the particle distribution in the liver can vary, resulting in radiation-induced complications. The present study aims to analyze the influence of a commercially available microcatheter with an angled tip and particle injection velocity in terms of segment-to-segment particle distribution. Specifically, four tip orientations and two injection velocities are combined to yield a set of eight numerical simulations of the particle-hemodynamics in a patient-specific truncated hepatic artery. For each simulation, four cardiac pulses are simulated. Particles are injected during the first cycle, and the remaining pulses enable the majority of the injected particles to exit the computational domain. Results indicate that, in terms of injection velocity, particles are more spread out in the cross-sectional lumen areas as the injection velocity increases. The tip's orientation also plays a role because it influences the near-tip hemodynamics, therefore altering the particle travel through the hepatic artery. However, results suggest that particle distribution tries to match the blood flow split, therefore particle injection velocity and microcatheter tip orientation playing a minor role in segment-to-segment particle distribution.