Numerical zero‐dimensional hepatic artery hemodynamics model for balloon‐occluded transarterial chemoembolization

• Published in: International journal for numerical methods in biomedical engineering 2018-07, Vol.34 (7), p.e2983-n/a
• Main Authors: Aramburu, Jorge, Antón, Raúl, Rivas, Alejandro, Ramos, Juan Carlos, Larraona, Gorka S., Sangro, Bruno, Bilbao, José Ignacio
• Format: Article
• Language: English
• Subjects: balloon‐occluded arterial stump pressure; Blood circulation; Blood flow; Boundary conditions; Cancer; Catheters; collateral circulation; communicating arcade; Communication; Computer simulation; Hemodynamics; Hepatic artery; Liver; liver cancer; Mathematical models; Medical instruments; Occlusion; Tumors; Veins & arteries
• ISSN: 2040-7939; 2040-7947
• DOI: 10.1002/cnm.2983

Balloon‐occluded transarterial chemoembolization (B‐TACE) is a valuable treatment option for patients with inoperable malignant tumors in the liver. Balloon‐occluded transarterial chemoembolization consists of the transcatheter infusion of an anticancer drug mixture and embolic agents. Contrary to conventional TACE, B‐TACE is performed via an artery‐occluding microballoon catheter, which makes the blood flow to redistribute due to the intra‐ and extrahepatic arterial collateral circulation. Several recent studies have stressed the importance of the redistribution of blood flow in enhancing the treatment outcome. In the present study, the geometries of a representative hepatic artery and the communicating arcades (CAs) are modeled. An in silico zero‐dimensional hemodynamic model is created by characterizing the geometry and the boundary conditions and then is validated in vitro. The role of CAs is assessed by combining 2 cancer scenarios and 2 catheter locations. The importance of the diameter of the CAs is also studied. Results show that occluding a main artery leads to collateral circulation and CAs start to play a role in blood‐flow redistribution. In summary, numerical zero‐dimensional simulations permit a fast and reliable approach for exploring the blood‐flow redistribution caused by the occlusion of a main artery, and this approach could be used during B‐TACE planning. Balloon‐occluded transarterial chemoembolization (TACE) is a novel treatment option for combatting liver tumors; balloon‐occluded TACE takes advantage of balloon‐occlusion‐caused collateral circulation to enhance the outcome of conventional TACE. This article presents a zero‐dimensional model of the hepatic artery and its communicating arcades that predicts the blood‐flow redistribution for any occlusion site and could make it possible to find the best location for the microballoon catheter for optimal treatment outcome.