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Dive into the research topics where Ciprian N. Ionita is active.

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Featured researches published by Ciprian N. Ionita.


Proceedings of SPIE | 2014

Challenges and limitations of patient-specific vascular phantom fabrication using 3D Polyjet printing

Ciprian N. Ionita; Maxim Mokin; Nicole Varble; Daniel R. Bednarek; Jianping Xiang; Kenneth V. Snyder; Adnan H. Siddiqui; Elad I. Levy; Hui Meng; Stephen Rudin

Additive manufacturing (3D printing) technology offers a great opportunity towards development of patient-specific vascular anatomic models, for medical device testing and physiological condition evaluation. However, the development process is not yet well established and there are various limitations depending on the printing materials, the technology and the printer resolution. Patient-specific neuro-vascular anatomy was acquired from computed tomography angiography and rotational digital subtraction angiography (DSA). The volumes were imported into a Vitrea 3D workstation (Vital Images Inc.) and the vascular lumen of various vessels and pathologies were segmented using a “marching cubes” algorithm. The results were exported as Stereo Lithographic (STL) files and were further processed by smoothing, trimming, and wall extrusion (to add a custom wall to the model). The models were printed using a Polyjet printer, Eden 260V (Objet-Stratasys). To verify the phantom geometry accuracy, the phantom was reimaged using rotational DSA, and the new data was compared with the initial patient data. The most challenging part of the phantom manufacturing was removal of support material. This aspect could be a serious hurdle in building very tortuous phantoms or small vessels. The accuracy of the printed models was very good: distance analysis showed average differences of 120 μm between the patient and the phantom reconstructed volume dimensions. Most errors were due to residual support material left in the lumen of the phantom. Despite the post-printing challenges experienced during the support cleaning, this technology could be a tremendous benefit to medical research such as in device development and testing.


Stroke | 2009

The Asymmetric Vascular Stent. Efficacy in a Rabbit Aneurysm Model

Ciprian N. Ionita; Ann M. Paciorek; A Dohatcu; Kenneth R. Hoffmann; Daniel R. Bednarek; John Kolega; Elad I. Levy; L. Nelson Hopkins; Stephen Rudin; J. Duffy Mocco

Background and Purpose— Development of hemodynamic modifying devices to treat intracranial aneurysms is an active area of research. The asymmetrical vascular stent (AVS), a stent containing a low-porosity patch, is such device. We evaluate AVS efficacy in an in vivo intracranial aneurysm model. Methods— We created 24 elastase rabbit model aneurysms: 13 treated with the AVS, 5 treated with standard coronary stents, and 6 untreated controls. Four weeks after treatment, aneurysms underwent follow-up angiography, cone-beam micro-CT, histological evaluation, and selective electron microscopy scanning. Results— Four rabbits died early in the study: 3 during AVS treatment and 1 control (secondary to intraprocedural vessel injury and an unrelated tumor, respectively). AVS-treated aneurysms exhibited very weak or no aneurysm flow immediately after treatment and no flow in all aneurysms at follow-up. Standard stent-treated aneurysms showed flow both after treatment (5/5) and at follow-up (3/5). All control aneurysms remained patent during the study. Micro-CT scans showed: 9 of 9 scanned AVS aneurysms were occluded, 6 of 9 AVS were ideally placed, and 3 of 9 low-porosity region partially covered the aneurysm neck; standard stent-treated aneurysms were 1 of 5 occluded, 2 of 5 patent, and 2 of 5 partially patent. Histology results demonstrated: for AVS-treated aneurysms, advanced thrombus organization in the (9/9); for standard stent-treated aneurysms, (1/4) no thrombus, (2/4) partially thrombosed, and (1/4) fully thrombosed; for control aneurysms (4/4), no thrombus. Conclusion— The use of AVS shows promise as a viable new therapeutic in intracranial aneurysm treatment. These data encourage further investigation and provide substantial support to the AVS concept.


Journal of NeuroInterventional Surgery | 2015

Primary stentriever versus combined stentriever plus aspiration thrombectomy approaches: in vitro stroke model comparison

Maxim Mokin; Ciprian N. Ionita; Swetadri Vasan Setlur Nagesh; Stephen Rudin; Elad I. Levy; Adnan H. Siddiqui

Background Artificial stroke models can be used for testing various thrombectomy devices. Objective To determine the value of combined stentriever–aspiration thrombectomy compared with the stentriever-alone approach. Methods We designed an in vitro model of the intracranial circulation with a focus on the middle cerebral artery (MCA) that closely resembles the human intracranial circulation. After introducing fresh clot in the MCA, we used conventional biplane angiography and microangiographic fluoroscopy to compare recanalization rates and occurrence of emboli in new, unaffected territory for thrombectomy approaches in which a stentriever (Solitaire flow restoration stentriever, Covidien) was used alone or in combination with continuous manual aspiration through a Navien catheter (Covidien). Results In a total of 22 experiments (11 for each approach), successful clot delivery to the MCA was achieved in all cases. Successful angiographic recanalization (thrombolysis in cerebral infarction score of 2b–3) was achieved more frequently with the combined stentriever–aspiration approach than with the stentriever-alone approach (in 10 vs 4 experiments, p=0.023). Emboli in new territory occurred in three experiments with the stentriever-alone approach, and none were seen with the combined approach (p=0.21). Conclusions The combined stentriever–aspiration approach to thrombectomy leads to better angiographic recanalization rates than use of the stentriever alone. Further experiments are needed to test the value of balloon-guide catheters and aspiration performed using other types of catheters and modes of aspiration.


American Journal of Neuroradiology | 2015

Comparison of Modern Stroke Thrombectomy Approaches Using an In Vitro Cerebrovascular Occlusion Model

Maxim Mokin; S Setlur Nagesh; Ciprian N. Ionita; Elad I. Levy; Siddiqui Ah

BACKGROUND AND PURPOSE: A new in vitro cerebrovascular occlusion model of the intracranial circulation was developed recently for testing thrombectomy devices. Using this model, we compared recanalization success associated with different modern endovascular thrombectomy approaches. MATERIALS AND METHODS: Model experiments were performed in 4 thrombectomy test groups: 1) primary or direct Stentriever thrombectomy with a conventional guide catheter (control group), 2) primary Stentriever thrombectomy with a balloon-guide catheter, 3) combined Stentriever–continuous aspiration approach, and 4) direct aspiration alone. Successful recanalization was defined as a TICI score of 2b or 3. RESULTS: Seventy-one thrombectomy experiments were conducted. Similar rates of TICI 2b–3 scores were achieved with balloon-guide and conventional guide catheters (P = .34). The combined Stentriever plus aspiration approach and the primary aspiration thrombectomy resulted in significantly higher rates of TICI 2b or 3 than the conventional guide-catheter approach in the control group (P = .008 and P = .0001, respectively). The primary Stentriever thrombectomy with the conventional guide catheter showed the highest rate of embolization to new territories (53%). CONCLUSIONS: Data from our in vitro model experiments show that the Stentriever thrombectomy under continuous aspiration and primary aspiration thrombectomy approaches led to the highest degree of recanalization.


Medical Imaging 2004: Physiology, Function, and Structure from Medical Images | 2004

Particle image velocimetry (PIV) evaluation of flow modification in aneurysm phantoms using asymmetric stents

Ciprian N. Ionita; Yei Hoi; Hui Meng; Stephen Rudin

Asymmetric stents are promising new devices for endovascular treatment of cerebrovascular aneurysms. For in vitro experiment a patch made of stainless steel mesh is directly attached onto a standard stent and deployed so that the patch is placed over the aneurysm orifice. hus we modify substantially the flow into the aneurysm and decrease the shear stress on the aneurysm walls. We used mesh-patches having different permeabilities and evaluated the flow using Particle Image Velocimetry. PIV provides instantaneous velocity vector measurements in a cross-section of flow containing reflective micro-particles. A pulsed-laser light sheet illuminates the flow in the target area and images are acquired using a CCD camera. By registering the position of the particles in two successive images the fluid velocity vectors components are calculated. From the 2D velocity field a best polynomial fit is made to obtain a smooth function of each velocity with respect to the coordinates. Using the fit, we derived the values of quantities of interest in the plane of acquisition such as: tangent shear stress, vorticity and inflow. We used four meshes of different permeabilities. We found out that by using lower permeability meshes we create better conditions for the embolization of the aneurysm.


Medical Physics | 2011

A theoretical and experimental evaluation of the microangiographic fluoroscope: A high‐resolution region‐of‐interest x‐ray imager

Amit Jain; Daniel R. Bednarek; Ciprian N. Ionita; Stephen Rudin

PURPOSE The increasing need for better image quality and high spatial resolution for successful endovascular image-guided interventions (EIGIs) and the inherent limitations of the state-of-the-art detectors provide motivation to develop a detector system tailored to the specific, demanding requirements of neurointerventional applications. METHOD A microangiographic fluoroscope (MAF) was developed to serve as a high-resolution, region-of-interest (ROI) x-ray imaging detector in conjunction with large lower-resolution full field-of-view (FOV) state-of-the-art x-ray detectors. The newly developed MAF is an indirect x-ray imaging detector capable of providing real-time images (30 frames per second) with high-resolution, high sensitivity, no lag and low instrumentation noise. It consists of a CCD camera coupled to a Gen 2 dual-stage microchannel plate light image intensifier (LII) through a fiber-optic taper. A 300 microm thick CsI(T1) phosphor serving as the front end is coupled to the LII. The LII is the key component of the MAF and the large variable gain provided by it enables the MAF to operate as a quantum-noise-limited detector for both fluoroscopy and angiography. RESULTS The linear cascade model was used to predict the theoretical performance of the MAF, and the theoretical prediction showed close agreement with experimental findings. Linear system metrics such as MTF and DQE were used to gauge the detector performance up to 10 cycles/mm. The measured zero frequency DQE(0) was 0.55 for an RQA5 spectrum. A total of 21 stages were identified for the whole imaging chain and each stage was characterized individually. CONCLUSIONS The linear cascade model analysis provides insight into the imaging chain and may be useful for further development of the MAF detector. The preclinical testing of the prototype detector in animal procedures is showing encouraging results and points to the potential for significant impact on EIGIs when used in conjunction with a state-of-art flat panel detector (FPD).


Stroke | 2008

Asymmetric Vascular Stent: Feasibility Study of a New Low-Porosity Patch-Containing Stent

Ciprian N. Ionita; Ann M. Paciorek; Kenneth R. Hoffmann; Daniel R. Bednarek; Junichi Yamamoto; John Kolega; Elad I. Levy; L. Nelson Hopkins; Stephen Rudin; J Mocco

Background and Purpose— Intracranial aneurysm (IA) treatment through hemodynamic modification with novel stent designs is a burgeoning area of research. We present a feasibility study for a new low-porosity patch-containing stent designed to treat intracranial aneurysms. The device is deployed so the patch covers the aneurysm neck ensuring strong flow diversion away from the aneurysm while keeping a low probability of occlusion of perforating vessels. Methods— We created 17 side-wall aneurysms in 6 dogs, 2 per carotid artery if animal size permitted. Twelve proximal aneurysms were treated with AVSs: 5 distal aneurysms were untreated, serving as controls against self-thrombosis; 7 treated aneurysms were fully-covered; and 5 were partially-covered. After 4 weeks, a final angiogram was performed and aneurysms were explanted. Angiograms acquired pre- and posttreatment and at 4-week follow-up were analyzed quantitatively using normalized time-density curves (NTDC). Cone-beam micro-CT and histological specimen analysis were then performed. Results— Posttreatment, NTDC average peaks dropped to 45% of initial values for the partially-covered aneurysms and 78% for the fully-covered aneurysms. Cone-beam micro-CT imaging performed at 4 weeks posttreatment showed partial thrombosis in 4 of 5 partially-covered aneurysms and complete thrombosis in all fully-covered aneurysms. Histology revealed neointimal coverage of all asymmetrical patch regions and thrombus formation in both fully- and partially-covered aneurysms. Four-week follow-up was not done for 1 animal (2 controls, 2 treated) that expired because of groin hemorrhage and for another animal (1 aneurysm) with an occluded carotid. Conclusions— We demonstrate aneurysmal blood flow diversion using a new low-porosity patch-containing asymmetrical vascular stent in a canine side-wall aneurysm model. Overall results are encouraging and support continued AVS development.


Journal of Digital Imaging | 2008

Cone-Beam Micro-CT System Based on LabVIEW Software

Ciprian N. Ionita; Kenneth R. Hoffmann; Daniel R. Bednarek; R Chityala; Stephen Rudin

Construction of a cone-beam computed tomography (CBCT) system for laboratory research usually requires integration of different software and hardware components. As a result, building and operating such a complex system require the expertise of researchers with significantly different backgrounds. Additionally, writing flexible code to control the hardware components of a CBCT system combined with designing a friendly graphical user interface (GUI) can be cumbersome and time consuming. An intuitive and flexible program structure, as well as the program GUI for CBCT acquisition, is presented in this note. The program was developed in National Instrument’s Laboratory Virtual Instrumentation Engineering Workbench (LabVIEW) graphical language and is designed to control a custom-built CBCT system but has been also used in a standard angiographic suite. The hardware components are commercially available to researchers and are in general provided with software drivers which are LabVIEW compatible. The program structure was designed as a sequential chain. Each step in the chain takes care of one or two hardware commands at a time; the execution of the sequence can be modified according to the CBCT system design. We have scanned and reconstructed over 200 specimens using this interface and present three examples which cover different areas of interest encountered in laboratory research. The resulting 3D data are rendered using a commercial workstation. The program described in this paper is available for use or improvement by other researchers.


Medical Imaging 2002: Physics of Medical Imaging | 2002

Micro-angiographic detector with fluoroscopic capability

Stephen Rudin; Ye Wu; Iacovos S. Kyprianou; Ciprian N. Ionita; Z Wang; Arundhuti Ganguly; Daniel R. Bednarek

New neuro-interventional devices such as stents require high spatial-resolution image guidance to enable accurate localization both along the vessel axis as well as in a preferred rotational orientation around the axis. A new high-resolution angiographic detector has been designed with capability for micro-angiography at rates exceeding the 5 fps of our current detector and, additionally, with noise low enough and gain high enough for fluoroscopy. Although the performance requirements are demanding and the detector must fit within practical clinical space constraints, image guidance is only needed within a approximately 5 cm region of interest at the site of the intervention. To achieve the design goals, the new detector is being assembled from available components which include a CsI(Tl) phosphor module coupled to a fiber-optic taper assembly with a two stage light image intensifier and a mirror between the output of the fiber taper and the input to a conventional high performance optical CCD camera. Resulting acquisition modes include 50-micron effective pixels at up to 30 fps with the capability to adjust sensitivity for both fluoroscopy and angiography. Estimates of signal at the various stages of detection are made with quantum accounting diagrams (QAD).


Medical Imaging 2005: Visualization, Image-Guided Procedures, and Display | 2005

Microangiographic image-guided localization of a new asymmetric stent for treatment of cerebral aneurysms

Ciprian N. Ionita; Stephen Rudin; Kenneth R. Hoffmann; Daniel R. Bednarek

For treatment of cerebral aneurysms, the low porosity patch-like region of a new asymmetric stent must be accurately aligned both longitudinally and rotationally to cover the aneurysm orifice. Image guided interventions (IGI) for this task using either a high spatial resolution microangiographic detector (MA) or a standard x-ray image intensifier (XII) are compared. MA is a custom built phosphor-fiberoptic-CCD x-ray detector; the MA array is 1024X1024 with 43 microns pixels. We designed an experimental simulation of the IGI which involved localization using a combination of a computer-controlled rotational stage supported on a linear traverse. A catheter containing the asymmetric stent with special gold markers was positioned near the aneurysm of a vessel phantom which is contained in a flow loop to enable contrast injection for creation of roadmap images. We used four different configurations for the markers consisting of dots and lines. The true stent alignment, obtained by direct visual viewing, was determined to better than one degree rotational accuracy. The resultant IGI localization accuracy under radiographic control with the microangiographic detector was 4° compared to 12° for the XII. In general the line markers performed better than the dot markers. Experimental data show that high resolution detectors such as MA can vastly improve the accuracy of localization and tracking of devices such as asymmetric stents. This should enable development of more effective treatment devices and interventions. (Partial support from NIH grants NS38746, NS43294, and EB002873; UB STOR, Toshiba MSC, and Guidant Corp.)

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S Rudin

University at Buffalo

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Amit Jain

University at Buffalo

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A Jain

University at Buffalo

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