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Rheology of Sclerosant Foam in in-vitro. M.Phil in Mechanical Engineering KAICHUNG WONG | SID : 310334209.

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Presentation on theme: "Rheology of Sclerosant Foam in in-vitro. M.Phil in Mechanical Engineering KAICHUNG WONG | SID : 310334209."— Presentation transcript:

1 Rheology of Sclerosant Foam in in-vitro. M.Phil in Mechanical Engineering KAICHUNG WONG | SID :

2 Nature of Varicose Vein ›Varicose veins are chronic abnormally dilated veins, usually involving the superficial veins of the upper and lower leg (Kumar et al., 2007). ›The function of healthy veins are carry blood towards the heart with flow driven by muscle movements around the vein, with flow directed by bicuspid valves which regulate the blood flow in one direction. Kumar V, Abbas A, Fausto N, R M. Robbins Basic Pathology, 8th edition. In: Kumar V, editor.: Saunders Elsevier; p. 370.

3 Clinical Treatment ›Sclerotherapy -Foam sclerotherapy is to treat varicose veins and rarer venous conditions such as venous malformations (Bergen et al., 2006; Redendo et al., 2009; Rehman et al., 2009). -Sodium Tetradecyl Sulphate (STS) and Polidocanol (POL) injure the endothelial cell membrane phospholipid bilayer, transforming the venous structure into a fibrous cord that cannot be recanalized (Redendo et al., 2005). Bergan J, Pascarella L, Mekenas L. Venous disorders: treatment with sclerosant foam. J Cardiovasc Surg. [Review] Feb;47(1):9-18. Redondo P, Bastarrika G, Sierra A, Martinez-Cuesta A, Cabrera J. Efficacy and Safety of Microfoam Sclerotherapy in a Patient With Klippel-Trenaunay Syndrome and a Patent Foramen Ovale. Arch Dermatol. [Article] Oct;145(10): Rehman KU, Sittampalam G, McCafferty I, Monaghan A. The use of foam sclerotherapy for the treatment of head and neck vascular malformations. Br J Oral Maxillofac Surg. [Article] Dec;47(8): Redondo P, Cabrera J. Microfoam sclerotherapy. Semin Cutan Med Surg. [Article] Dec;24(4):

4 Clinical Treatment -The best foam was produced by mixing one part liquid STS and four parts air (Tessari et al, 2001). -Injection of foam introduces air into the circulation which can lead to serious complications caused by air emboli. Such complications of foam sclerotherapy include both reversible events and serious events such as stroke. (Forlee et all, 2006; Bush et al, 2008; Hahn et al, 2010). TESSARI, L., CAVEZZI, A. and FRULLINI, A., (2001) Preliminary experience with a new sclerosinhg foam in the treatment of varicose veins. Dermatol. Surg., 27, 58 – 60. Forlee, M.V., Grouden, M., Moore, D.J., Shanik, G. Stroke after varicose vein foam injection sclerotherapy. J Vasc Surg. [Article] Jan;43(1): Bush, R.G., Derrick, M., Manjoney, D. Major neurological events following foam sclerotherapy. Phlebology. [Article]. 2008;23(4): Hahn, M., Schulz, T., Junger. M. Late stroke after foam sclerotherapy. Vasa. [Article] Feb;39(1):

5 Foam Generation Courtesy :

6 Project Aims ›Determine the basic physical properties of Sclerosants in liquid and foam form which include: viscosity, surface tension and density by means of performing experiments at University laboratories. These data will be essential for computational works. ›To understand the flow behaviour of sclerosants liquid and Sclerosants foam and blood in the Saphenofemoral Junction (SFV) with and without angle by means of computational model and experimental model.

7 Basic Physical Properties Density measurement –Weight with fixed and expansion volume method Pipette (Gilson Pipetman P1000) and digital balance (Sartorius – Analytic – A200S) Surface Tension Measurement –Du Nuoy Ring method KSV Sigma 70 Surface Tensiometer. Viscosity Measurement –Parallel Plates method Physica MCR 301.

8 CFD Model ›Numerical Analysis: -Commercial CFD Software – ANSYS Workstation

9 Refined Sapherofemoral Junction Case

10 Experimental Model

11 POL Density

12 STS Density

13 Foam Density Measurement

14 POL CMC and Surface Tension Measurement CMC at 1mM or 0.055% w/v

15 STS CMC and Surface Tension Measurement

16 STS Foam Viscosity Properties

17

18 CFD Analysis (Liquid POL and blood) Boundary Condition : 2.0m/s POL inlet, 0.01m/s Superficial Vein inlet and 0.02m/s Femoral Vein inlet at t = s

19 CFD Analysis (Liquid POL and blood) Boundary Condition : 2.0m/s POL inlet at t = 10.00s 0 Pa for all outlets.

20 In-Vitro Experiment STS Foam (0.5mL STS + 2mL Air)

21 In-Vitro Experiment STS Foam (1+4)

22

23 All photos are 0.7s interval.

24 Future Direction Apply at least one more viscosity model for comparison. Incorporate syringe into the geometry where moving boundary will be applied to syringe for meaningful simulations’ results. Simulate when patient’s leg were lift up in an angle on the Sapherofemoral joint case emphasizing on sclerosant foam.


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