@incollection{Raptis, author = {Raptis, Georgios}, title = {Privacy and Data Protection: Mission Impossible?}, series = {Consumer Health Informatics}, booktitle = {Consumer Health Informatics}, editor = {Wetter, Thomas}, publisher = {Springer International Publishing}, isbn = {978-3-319-19589-6}, doi = {10.1007/978-3-319-19590-2}, pages = {273 -- 280}, abstract = {Medical confidentiality is very important because it builds the fundament of trust between doctors and patients. In modern health services data protection is essential. But there are also other important security objectives, such as integrity and authenticity of medical data and health services, as their breach can potentially lead to life threatening conditions. State of the art security mechanisms are necessary to protect medical data and services and prevent attacks known as "hacking". They should include in particular cryptography, as you can usually rely on mathematics, more than in software security and access control mechanisms. As patients normally cannot assess the security of a service, security audits or certifications of health services should be provided to generate trust and confidence.}, subject = {Gesundheitswesen}, language = {en} } @incollection{Raptis, author = {Raptis, Georgios}, title = {Gew{\"a}hrleistung der IT-Sicherheit bei vernetzten Implantaten}, series = {Biomedizinische Technik: Vernetzte und intelligente Implantate}, booktitle = {Biomedizinische Technik: Vernetzte und intelligente Implantate}, editor = {Marschner, Uwe and Clasbrummel, Bernhard and Dehm, Johannes}, publisher = {Walter de Gruyter}, isbn = {978-3-11-034927-6}, pages = {182 -- 192}, subject = {Implantat}, language = {de} } @article{LooNagarajuPathivadaetal., author = {Loo, Xuyan and Nagaraju, Bhavana and Pathivada, Sai and Bartsch, Alexander and Schratzenstaller, Thomas and Sattler, Robert and Monkman, Gareth J.}, title = {Electrical properties of bisphenol-A-free magnetoactive borosilicate polymers}, series = {AIP Advances}, volume = {14}, journal = {AIP Advances}, number = {5}, publisher = {AIP Publishing}, issn = {2158-3226}, doi = {10.1063/5.0203017}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-72936}, abstract = {The recent REACH regulations require the elimination of bisphenol-A and titanium dioxide from commercially available boron-based polymers. This has led to changes in some of the mechanical characteristics, which strongly influence the properties of magnetoactive borosilicate polymers. This work delivers results on the electrical properties and discusses some implications for future research using bisphenol-A and titanium-dioxide-free substitutes.}, language = {en} } @article{EigenbergerFelthausSchratzenstalleretal., author = {Eigenberger, Andreas and Felthaus, Oliver and Schratzenstaller, Thomas and Haerteis, Silke and Utpatel, Kirsten and Prantl, Lukas}, title = {The Effects of Shear Force-Based Processing of Lipoaspirates on White Adipose Tissue and the Differentiation Potential of Adipose Derived Stem Cells}, series = {cells}, volume = {11}, journal = {cells}, number = {16}, publisher = {MDPI}, address = {Basel}, doi = {10.3390/cells11162543}, pages = {13}, abstract = {Autologous lipotransfer is a promising method for tissue regeneration, because white adipose tissue contains a heterogeneous cell population, including mesenchymal stem cells, endothelial cells, immune cells, and adipocytes. In order to improve the outcome, adipose tissue can be processed before application. In this study, we investigated changes caused by mechanical processing. Lipoaspirates were processed using sedimentation, first-time centrifugation, shear-force homogenization, and second-time centrifugation. The average adipocyte size, stromal vascular cell count, and adipocyte depot size were examined histologically at every processing step. In addition, the adipose derived stem cells (ADSCs) were isolated and differentiated osteogenically and adipogenically. While homogenization causes a disruption of adipocyte depots, the shape of the remaining adipocytes is not changed. On average, these adipocytes are smaller than the depot adipocytes, they are surrounded by the ECM, and therefore mechanically more stable. The volume loss of adipocyte depots leads to a significant enrichment of stromal vascular cells such as ADSCs. However, the mechanical processing does not change the potential of the ADSCs to differentiate adipogenically or steogenically. It thus appears that mechanically processed lipoaspirates are promising for the reparation of even mechanically stressed tissue as that found in nasolabial folds. The changes resulting from the processing correspond more to a filtration of mechanically less stable components than to a manipulation of the tissue.}, language = {en} } @article{ObermaierLehleSchmidetal., author = {Obermaier, Lisa and Lehle, Karla and Schmid, Stefanie and Schmid, Christof and Schratzenstaller, Thomas}, title = {Introduction of a new ex vivo porcine coronary artery model: Evaluation of the direct vascular injury after stent implantation with and without dogbone effect}, series = {European Surgical Research}, volume = {63}, journal = {European Surgical Research}, number = {4}, publisher = {Karger}, address = {Basel}, issn = {1421-9921}, doi = {10.1159/000527883}, pages = {285 -- 293}, abstract = {Introduction: Neointimal hyperplasia after percutaneous coronary intervention remains a major determinant of in-stent restenosis (ISR). The extent of mechanical vessel injury correlates with ISR. A new ex vivo porcine stent model was introduced and evaluated comparing different stent designs. Methods: Coronary arteries were prepared from pig hearts from the slaughterhouse and used for ex vivo implantations of coronary stents. One basic stent design in two configurations (dogbone, DB; non-dogbone, NDB) was used. Vascular injury was determined according to a modified injury score (IS). Results: Standardized experimental conditions ensured comparable vessel dimensions and overstretch data. DB stents caused more severe IS compared to NDB stents. The mean IS and the IS at the distal end of all stents were significantly reduced for NDB stents (ISMean, DB, 1.16 ±0.12; NDB, 1.02 ±0.12; p=0.018; ISDist, DB, 1.39 ±0.28; NDB, 1.13 ±0.24; p=0.03). Discussion/Conclusion: The introduced ex-vivo model allowed the evaluation of different stent designs exclude unfavorable stent designs.}, language = {en} } @article{GeithNothdurfterHeimletal., author = {Geith, Markus A. and Nothdurfter, Laurenz and Heiml, Manuel and Agrafiotis, Emmanouil and Gruber, Markus and Sommer, Gerhard and Schratzenstaller, Thomas and Holzapfel, Gerhard A.}, title = {Quantifying stent-induced damage in coronary arteries by investigating mechanical and structural alterations}, series = {Acta Biomaterialia}, volume = {116}, journal = {Acta Biomaterialia}, number = {October}, publisher = {Elsevier}, doi = {10.1016/j.actbio.2020.08.016}, pages = {285 -- 301}, abstract = {Vascular damage develops with diverging severity during and after percutaneous coronary intervention with stent placement and is the prevailing stimulus for in-stent restenosis. Previous work has failed to link mechanical data obtained in a realistic in vivo or in vitro environment with data collected during imaging processes. We investigated whether specimens of porcine right coronary arteries soften when indented with a stent strut shaped structure, and if the softening results from damage mechanisms inside the fibrillar collagen structure. To simulate the multiaxial loading scenario of a stented coronary artery, we developed the testing device 'LAESIO' that can measure differences in the stress-stretch behavior of the arterial wall before and after the indentation of a strut-like stamp. The testing protocol was optimized according to preliminary experiments, more specifically equilibrium and relaxation tests. After chemical fixation of the specimens and subsequent tissue clearing, we performed three-dimensional surface and second-harmonic generation scans on the deformed specimens. We analyzed and correlated the mechanical response with structural parameters of high-affected tissue located next to the stamp indentation and low-affected tissue beyond the injured area. The results reveal that damage mechanisms, like tissue compression as well as softening, fiber dispersion, and the lesion extent, are direction-dependent, and the severity of them is linked to the strut orientation, indentation pressure, and position. The findings highlight the need for further investigations by applying the proposed methods to human coronary arteries. Additional data and insights might help to incorporate the observed damage mechanisms into material models for finite element analyses to perform more accurate simulations of stent-implantations.}, language = {en} } @inproceedings{WiesentGeithWagner, author = {Wiesent, Lisa and Geith, Markus A. and Wagner, Marcus}, title = {Simulation of Fluid-Structure Interaction between injection medium and balloon catheter using ICFD}, series = {11th European LS-DYNA Conference 2017, 9 - 11 May, Salzburg, Austria}, booktitle = {11th European LS-DYNA Conference 2017, 9 - 11 May, Salzburg, Austria}, isbn = {978-3981621549}, abstract = {Arteriosclerosis is a major health issue worldwide. While it is commonly treated by the implantation of an balloon-expandable stent, micro injuries may occur during stent deployment, and induce in-stent restenosis, whose consequence can be fatal. Studying this undesirable phenomenon is usually limited as experimental data is hard to obtain on ethical ground. Numerical simulation are performed to better understand this problem. To construct a more realistic simulation of a balloon-expandable stent, a partitioned strongly-coupled FSI simulation of the balloon deployment was set up using the ICFD solver of LS-DYNA, - a quite innovative approach. The complex balloon configuration as well as the interaction of the injection medium and the balloon structure was considered. The balloon structure consisting of shell elements was obtained from preliminary balloon folding and pleating simulations. The balloon consists of a flexible thin walled polyamide. The injection fluid is implemented using volume elements. Balloon deployment was initiated by a pressure boundary condition inducing a volume flow into the balloon. The initial feasibility analysis showed promising result including a continuous balloon deployment and a reasonable development of the fluid pressure and velocity field. However, applying this FSI approach to a more complex balloon structure led to a non convergent solution. The non-convergence could be mainly reduced to mechanical factors including the low wall thickness of the balloon (< 0.05 mm) and the flexibility of the polyamide. Further, the ICFD solver shows less accuracy concerning the FSI conditions when dealing with thin flexible structures as well as enclosed volumes. A shell thickness of 0.06 mm is believed to result in a convergent solution.}, subject = {Koronare Herzkrankheit}, language = {en} } @article{WiesentSchultheissSchmidetal., author = {Wiesent, Lisa and Schultheiss, Ulrich and Schmid, Christof and Schratzenstaller, Thomas and Nonn, Aida}, title = {Experimentally validated simulation of coronary stents considering different dogboning ratios and asymmetric stent positioning}, series = {PlOS One}, volume = {14}, journal = {PlOS One}, number = {10}, publisher = {PLOS}, doi = {10.1371/journal.pone.0224026}, pages = {1 -- 25}, abstract = {In-stent restenosis remains a major problem of arteriosclerosis treatment by stenting. Expansion-optimized stents could reduce this problem. With numerical simulations, stent designs/ expansion behaviours can be effectively analyzed. For reasons of efficiency, simplified models of balloon-expandable stents are often used, but their accuracy must be challenged due to insufficient experimental validation. In this work, a realistic stent life-cycle simulation has been performed including balloon folding, stent crimping and free expansion of the balloon-stent-system. The successful simulation and validation of two stent designs with homogenous and heterogeneous stent stiffness and an asymmetrically positioned stent on the balloon catheter confirm the universal applicability of the simulation approach. Dogboning ratio, as well as the final dimensions of the folded balloon, the crimped and expanded stent, correspond well to the experimental dimensions with only slight deviations. In contrast to the detailed stent life-cycle simulation, a displacement-controlled simulation can not predict the transient stent expansion, but is suitable to reproduce the final expanded stent shape and the associated stress states. The detailed stent life-cycle simulation is thus essential for stent expansion analysis/optimization, whereas for reasons of computational efficiency, the displacement-controlled approach can be considered in the context of pure stress analysis.}, subject = {Stent}, language = {en} } @article{GeithSwidergalHochholdingeretal., author = {Geith, Markus A. and Swidergal, Krzysztof and Hochholdinger, Bernd and Schratzenstaller, Thomas and Wagner, Marcus and Holzapfel, Gerhard A.}, title = {On the importance of modeling balloon folding, pleating, and stent crimping: An FE study comparing experimental inflation tests}, series = {International Journal for Numerical Methods in Biomedical Engineering}, volume = {35}, journal = {International Journal for Numerical Methods in Biomedical Engineering}, number = {11}, publisher = {Wiley}, doi = {10.1002/cnm.3249}, abstract = {Finite element (FE)-based studies of preoperative processes such as folding,pleating, and stent crimping with a comparison with experimental inflation tests are not yet available. Therefore, a novel workflow is presented in which residual stresses of balloon folding and pleating, as well as stent crimping, and the geometries of all contact partners were ultimately implemented in an FE code to simulate stent expansion by using an implicit solver. The numerical results demonstrate that the incorporation of residual stresses and strains experienced during the production step significantly increased the accuracy of the subsequent simulations, especially of the stent expansion model. During the preoperative processes, stresses inside the membrane and the stent material also reached a rather high level. Hence, there can be no presumption that balloon catheters or stents are undamaged before the actual surgery. The implementation of the realistic geometry, in particular the balloon tapers, and the blades of the process devices improved the simulation of the expansion mech-anisms, such as dogboning, concave bending, or overexpansion of stent cells. This study shows that implicit solvers are able to precisely simulate the mentioned preoperative processes and the stent expansion procedure without a preceding manipulation of the simulation time or physical mass.}, subject = {Stent}, language = {en} } @misc{WiesentHupkeBalketal., author = {Wiesent, Lisa and Hupke, Constantin and Balk, Christian and Schultheiss, Ulrich and Schratzenstaller, Thomas}, title = {Optimization of the cardiovascular stent design towards improved expansion behaviour and radial stiffness properties}, series = {Biomedizinische Technik}, volume = {63}, journal = {Biomedizinische Technik}, number = {s1}, doi = {10.1515/bmt-2018-6031}, abstract = {- Development of a FEA Tool for a realistic stent simulation - investigation on minor modification on the stent design on the expansion behaviour - analysis of three stent designs: classical stent design with pronounced dogbone effect, two modified stent design (non-dogbone-design)}, subject = {Kardiovaskul{\"a}res System}, language = {en} }