Caractérisation de la génération et la propagation d'ondes de pressions dans des tissus biologiques pour la conception d'appareils médicaux

Therapies using so called extracorporeal shock waves (Extracorporeal Shock Wave Therapy ESWT) have become current medical practice in orthopedy and traumatology. In order to understand and to optimize the effect of shock waves in clinical applications, medical results must be correlated with well characterized mechanical stimuli. This thesis has an industrial scope. It contributes to the comprehension of the generation and propagation of pressure waves in human tissues with the aim of improving existing ESWT therapies and of providing the industrial partner with tools for the design of a new generation of extracorporeal shock waves devices. The adopted general approach is based on a combination of experimental characterization and analytical and numerical modeling of wave generation and propagation phenomena in a medical treatment device and in biological tissues. Firstly, the characterization of a wave generator is based, on the one hand, on measurements of the dynamic behavior of the moving parts coupled with rigid body simulation, and on the other hand on measurements of wave propagation by means of a Hopkinson bar coupled with finite elements simulations. This characterization has shown that the generator produces very reproducible stress pulses. The simulation technique allows designing a new wave generator with a higher energy range and with well controlled operating parameters. The new design is covered by a patent. Secondly, a measurement technique for generation and propagation of pressure waves in soft animal tissues has been developed that is based on PVDF gages. The applicability of these gages has been qualitatively validated by comparative measurements with a Hopkinson bar. The perturbation effect of the gage, acting as an inclusion in the medium to be characterized, has been evaluated by means of simulations of wave propagation in water. Comparison with measurements in soft tissues suggests that it is negligible for pressure measurement in this type of materials. An independent calibration of the gage could however not be performed. Finally, measurements of wave propagation in pig skin and fat using PVDF gauges showed good reproducibility for a given sample. They highlighted the influence of the supply pressure of the wave generator on the amplitude and on the attenuation of the wave in tissues. Moreover, the dependence between the amplitude of the wave and its propagation velocity suggests a non-linear viscoelastic behavior of soft tissues as well as the need of a constitutive model for high strain rates. Simulations of wave propagation using a known hyperelastic constitutive model highlighted the difficulty of modeling such soft tissues. A viscoelastic non-linear constitutive model based on power laws was considered and is an interesting candidate for future simulations. The simulation technique for wave generation and propagation in a solid (aluminum) and a liquid (water) has been validated by comparing its results with measurements performed in these materials (strain gages and PVDF hydrophone respectively). Simulations of pressure wave propagation validated for solids and liquids showed that they can be applied to biological tissues modeled using a known constitutive model; they are a tool for any other simulation using more complex constitutive models. This work contributes to a broader study aimed at establishing and validating constitutive models for biological materials suitable for use in simulations of wave propagation.

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