Antón-Remírez, R. (Raúl)
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- In Vitro Model for Simulating Drug Delivery during Balloon-Occluded Transarterial Chemoembolization.(MDPI, 2021) Aramburu-Montenegro, J. (Jorge); Antón-Remírez, R. (Raúl); Fukamizu, J. (Junichi); Nozawa, D. (Daiki); Ramos-González, J. (Juan Carlos); Sangro, B. (Bruno); Bilbao-Jaureguízar, J. (José Ignacio); Tomita, K. (Kosuke); Matsumoto, T. (Tomohiro); Hasebe, T. (Teremitsu)Simple Summary Liver cancer is one of the leading causes of cancer-related deaths worldwide and balloon-occluded transarterial chemoembolization (B-TACE) has emerged as a safe and effective treatment for liver cancer. However, the hemodynamic alterations that are responsible for the successfulness of the treatment and are produced by the microballoon catheter used during the treatment are not yet well understood. In this study, we developed an in vitro model (IVM) that can simulate B-TACE. We designed clinically relevant experiments, and we obtained clinically realistic results. We conclude that the IVM allows for a visual understanding of a complex phenomenon (i.e., the blood flow redistribution after balloon occlusion) and it could be used as a base for future sophisticated and even patient-specific IVMs; in addition, it could be used to conduct IVM-based research on B-TACE. Background: Balloon-occluded transarterial chemoembolization (B-TACE) has emerged as a safe and effective procedure for patients with liver cancer, which is one of the deadliest types of cancer worldwide. B-TACE consist of the transcatheter intraarterial infusion of chemotherapeutic agents, followed by embolizing particles, and it is performed with a microballoon catheter that temporarily occludes a hepatic artery. B-TACE relies on the blood flow redistribution promoted by the balloon-occlusion. However, flow redistribution phenomenon is not yet well understood. Methods: This study aims to present a simple in vitro model (IVM) where B-TACE can be simulated. Results: By visually analyzing the results of various clinically-realistic experiments, the IVM allows for the understanding of balloon-occlusion-related hemodynamic changes and the importance of the occlusion site. Conclusion: The IVM can be used as an educational tool to help clinicians better understand B-TACE treatments. This IVM could also serve as a base for a more sophisticated IVM to be used as a research tool.
- Computational particle–haemodynamics analysis of liver radioembolization pretreatment as an actual treatment surrogate(Willey, 2017-02) Aramburu-Montenegro, J. (Jorge); Sangro, B. (Bruno); Bilbao, J.I. (José I.); Ramos-González, J. (Juan Carlos); Rivas-Nieto, A. (Alejandro); Antón-Remírez, R. (Raúl)Liver radioembolization (RE) is a treatment option for patients with unresectable and chemorefractory primary and metastatic liver tumours. RE consists of intra-arterially administering via catheter radioactive microspheres that locally attack the tumours, sparing healthy tissue. Prior to RE, the standard practice is to conduct a treatment-mimicking pretreatment assessment via the infusion of Tc-99m-labelled macroaggregated albumin microparticles. The usefulness of this pretreatment has been debated in the literature, and thus, the aim of the present study is to shed light on this issue by numerically simulating the liver RE pretreatment and actual treatment particle-haemodynamics in a patient-specific hepatic artery under two different literature-based cancer scenarios and two different placements of a realistic end-hole microcatheter in the proper hepatic artery. The parameters that are analysed are the following: microagent quantity and size (accounting for RE pretreatment and treatment),...
- The role of angled-tip microcatheter and microsphere injection velocity in liver radioembolization: A computational particle–hemodynamics study.(Wiley, 2017-12) Aramburu-Montenegro, J. (Jorge); Sangro, B. (Bruno); Bilbao, J.I. (José I.); Ramos-González, J. (Juan Carlos); Rivas-Nieto, A. (Alejandro); Antón-Remírez, R. (Raúl)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, 4 tip orientations and 2 injection velocities are combined to yield a set of 8 numerical simulations of the particle-hemodynamics in a patient-specific truncated hepatic artery. For each simulation, 4 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.
- Liver cancer arterial perfusion modelling and CFD boundary conditions methodology: a case study of the haemodynamics of a patient-specific hepatic artery in literature-based healthy and tumour-bearing liver scenarios(Willey, 2016-11) Aramburu-Montenegro, J. (Jorge); Sangro, B. (Bruno); Bilbao, J.I. (José I.); Ramos-González, J. (Juan Carlos); Rivas-Nieto, A. (Alejandro); Antón-Remírez, R. (Raúl)Some of the latest treatments for unresectable liver malignancies (primary or metastatic tumours), which include bland embolisation, chemoembolisation, and radioembolisation, among others, take advantage of the increased arterial blood supply to the tumours to locally attack them. A better understanding of the factors that influence this transport may help improve the therapeutic procedures by taking advantage of flow patterns or by designing catheters and infusion systems that result in the injected beads having increased access to the tumour vasculature. Computational analyses may help understand the haemodynamic patterns and embolic-microsphere transport through the hepatic arteries. In addition, physiological inflow and outflow boundary conditions are essential in order to reliably represent the blood flow through arteries. This study presents a liver cancer arterial perfusion model based on a literature review and derives boundary conditions for tumour-bearing liver-feeding hepatic arteries based on the arterial perfusion characteristics of normal and tumorous liver segment tissue masses and the hepatic artery branching configuration. Literature-based healthy and tumour-bearing realistic scenarios are created and haemodynamically analysed for the same patient-specific hepatic artery. As a result, this study provides boundary conditions for computational fluid dynamics simulations that will allow researchers to numerically study, for example, various intravascular devices used for liver disease intra-arterial treatments with different cancer scenarios.
- Computational study of the microsphere concentration in blood during radioembolization(2022) Aramburu-Montenegro, J. (Jorge); Sangro, B. (Bruno); Lertxundi-Ferrán, U.(Unai); Rodriguez-Fraile, M. (Macarena); Antón-Remírez, R. (Raúl)Computational fluid dynamics techniques are increasingly used to computer simulate radioembolization, a transcatheter intraarterial treatment for patients with inoperable tumors, and analyze the influence of treatment parameters on the microsphere distribution. Ongoing clinical research studies are exploring the influence of the microsphere density in tumors on the treatment outcome. In this preliminary study, we computationally analyzed the influence of the microsphere concentration in the vial on the microsphere concentration in the blood. A patient-specific case was used to simulate the blood flow and the microsphere transport during three radioembolization procedures in which the only parameter varied was the concentration of microspheres in the vial and the span of injection, resulting in three simulations with the same number of microspheres injected. Results showed that a time-varying microsphere concentration in the blood at the outlets of the computational domain can be analyzed using CFD, and also showed that there was a direct relationship between the variation of microsphere concentration in the vial and the variation of microsphere concentration in the blood. Future research will focus on elucidating the relationship between the microsphere concentration in the vial, the microsphere concentration in the blood, and the final microsphere distribution in the tissue.
- Examen Termodinámica diciembre 2009(2009-12-14T17:46:53Z) Gómez-Acebo, T. (Tomás); Antón-Remírez, R. (Raúl)Examen final Termodinámica curso 2009-2010, convocatoria ordinaria
- Examen Termodinámica mayo 2013(2013-05-29) Gómez-Acebo, T. (Tomás); Antón-Remírez, R. (Raúl)Examen final Termodinámica curso 2012-2013, convocatoria ordinaria
- Computational assessment of the effects of the catheter type on particle–hemodynamics during liver radioembolization(Elsevier, 2016-11) Aramburu-Montenegro, J. (Jorge); Sangro, B. (Bruno); Bilbao, J.I. (José I.); Ramos-González, J. (Juan Carlos); Rivas-Nieto, A. (Alejandro); Antón-Remírez, R. (Raúl)Radioembolization, which consist of the implantation of radioactive microspheres via intra-arterially placed microcatheter, is a safe and effective treatment for liver cancer. Nevertheless, radioembolizationrelated complications and side effects may arise, which are an active area of ongoing research. The catheter design has been claimed as an option in reducing these complications. In this paper, the influence of catheter type and location are investigated. The study was undertaken by numerically simulating the particle-hemodynamics in a patient-specific hepatic artery during liver radioembolization. The parameters modified were cancer scenario (30% liver involvement in the right lobe, 'scenario A', and in both lobes, 'scenario B'), catheter type (standard end-hole microcatheter, SMC, and antireflux catheter, ARC), and the location of the tip in the proper hepatic artery (in the straight part, 'inlet', and near the bifurcation, 'bifurcation'). Comparing ARC with SMC, the maximum and average (over segments) absolute difference in the percentage of particles that reached each segment were 19.62% and 9.06% when injecting near the inlet for scenario A; 3.54% and 1.07% injecting near the bifurcation for scenario A; and 18.31% and 11.85% injecting near the inlet for scenario B. It seems, therefore, that the location of the catheter tip in the artery is crucial in terms of particle distribution. Moreover, even though the near-tip blood flow was altered due to the presence of a catheter, the particle distribution matched the flow split if the distance between the injection point and the first bifurcation encountered enabled the alignment of particles with blood flow.
- Examen Termodinámica junio 2010(2010-07-15T07:01:29Z) Gómez-Acebo, T. (Tomás); Antón-Remírez, R. (Raúl)Examen final Termodinámica curso 2009-2010, convocatoria extraordinaria
- Examen Termodinámica mayo 2011(2011-06-01T12:57:55Z) Gómez-Acebo, T. (Tomás); Antón-Remírez, R. (Raúl)Examen final Termodinámica curso 2010-2011, convocatoria ordinaria