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Impact of Cross-Limb Stent-Graft Configuration on Hemodynamics in Abdominal Aortic Aneurysm Interventional Therapy.

التفاصيل البيبلوغرافية
العنوان: Impact of Cross-Limb Stent-Graft Configuration on Hemodynamics in Abdominal Aortic Aneurysm Interventional Therapy.
المؤلفون: Xie Y; Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China., Zhu Y; Department of Vascular Surgery, First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China., Shi Y; College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China., Zhao Y; College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China., Zhang H; Department of Vascular Surgery, First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China., Li F; College of Mechanical and Vehicle Engineering, Taiyuan University of Technology, 79 West Yingze Street, Taiyuan, 030024, China. lifen01@tyut.edu.cn., Song H; College of Mechanical and Vehicle Engineering, Taiyuan University of Technology, 79 West Yingze Street, Taiyuan, 030024, China., Chen L; College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China., Guo W; Department of Vascular Surgery, First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. guoweiplagh@sina.com.
المصدر: Cardiovascular engineering and technology [Cardiovasc Eng Technol] 2024 Apr; Vol. 15 (2), pp. 137-146. Date of Electronic Publication: 2023 Nov 20.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 101531846 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1869-4098 (Electronic) Linking ISSN: 1869408X NLM ISO Abbreviation: Cardiovasc Eng Technol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Springer
مواضيع طبية MeSH: Aortic Aneurysm, Abdominal*/surgery , Aortic Aneurysm, Abdominal*/physiopathology , Aortic Aneurysm, Abdominal*/diagnostic imaging , Stents* , Endovascular Procedures*/instrumentation , Hemodynamics* , Models, Cardiovascular* , Prosthesis Design* , Blood Vessel Prosthesis Implantation*/instrumentation , Blood Vessel Prosthesis* , Aorta, Abdominal*/physiopathology , Aorta, Abdominal*/surgery , Aorta, Abdominal*/diagnostic imaging , Computed Tomography Angiography* , Stress, Mechanical* , Patient-Specific Modeling*, Humans ; Regional Blood Flow ; Aortography ; Blood Flow Velocity ; Numerical Analysis, Computer-Assisted ; Treatment Outcome
مستخلص: Purpose: The cross-limb (CL) technique is a commonly used endovascular treatment for addressing unfavorable anatomical features in patients with abdominal aortic aneurysm (AAA). The configuration of CL stent-graft plays a critical role in determining the postoperative hemodynamic properties and physiological behaviors, which ultimately impact the efficacy and safety of endovascular AAA treatment. This study aims to investigate the relationship between hemodynamics and CL stent-graft configuration from a hemodynamic perspective.
Methods: Five distinct geometric models of cross-limb (CL) stent-graft configurations were constructed by optimizing the real clinical computed tomography angiography (CTA) data. These models varied in main body lengths and cross angles and were used to perform numerical simulations to analyze various hemodynamic parameters. Flow pattern, distribution of wall shear stress (WSS)-related parameters, localized normalized helicity (LNH), pressure drop, and the displacement force of all models were examined in this paper.
Results: In patient-specific cases, helical flow and WSS increase with the main body. However, it also generated secondary flow in localized areas, leading to increased oscillation in the WSS direction. Notably, increasing the stent graft's main body length or decreasing the cross angle reduced the displacement force exerted on the stent-graft. Reducing the cross angle did not significantly alter the hemodynamic characteristics.
Conclusion: In the clinical practice of CL deployment, it is crucial to carefully consider the stent-graft configuration and the patient specific to achieve optimal postoperative outcomes. This study provides valuable insights for guiding stent selection and treatment planning in patients with abdominal aortic aneurysm undergoing CL techniques, from a hemodynamic perspective.
(© 2023. The Author(s) under exclusive licence to Biomedical Engineering Society.)
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معلومات مُعتمدة: CJ-HBIO202103 Foundation of Institute of Human Biomechanics; 12002231 National Natural Science Foundation of China; 7212095 Natural Science Foundation of Beijing Municipality; 2021J240 Ningbo Natural Science Foundation
فهرسة مساهمة: Keywords: Cross-limb configuration; Endovascular; Flow pattern; Hemodynamic; Wall shear stress
تواريخ الأحداث: Date Created: 20231120 Date Completed: 20240523 Latest Revision: 20240523
رمز التحديث: 20240524
DOI: 10.1007/s13239-023-00702-1
PMID: 37985614
قاعدة البيانات: MEDLINE
الوصف
تدمد:1869-4098
DOI:10.1007/s13239-023-00702-1