Partial renal coverage in endovascular aneurysm repair causes unfavorable renal flow patterns in an infrarenal aneurysm model
| Autor: | Esmé J. Donselaar, Michel M.P.J. Reijnen, Johannes T. Boersen, Jean-Paul P.M. de Vries, Erik Groot Jebbink, Clark J. Zeebregts, Lennart van de Velde, Guillaume Lajoinie, Michel Versluis |
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| Přispěvatelé: | Man, Biomaterials and Microbes (MBM), Robotics and image-guided minimally-invasive surgery (ROBOTICS), Multi-Modality Medical Imaging, Technical Medicine, Physics of Fluids |
| Rok vydání: | 2018 |
| Předmět: |
Models
Anatomic Time Factors Computed Tomography Angiography medicine.medical_treatment 030204 cardiovascular system & hematology Renal artery stenosis Endovascular aneurysm repair 030218 nuclear medicine & medical imaging Aortic aneurysm Renal Artery 0302 clinical medicine Risk Factors Aorta Abdominal BIFURCATION Endovascular Procedures Models Cardiovascular Abdominal aortic aneurysm cardiovascular system Stents Radiology Cardiology and Cardiovascular Medicine Blood Flow Velocity STENT-GRAFT IMAGE VELOCIMETRY medicine.medical_specialty PULSATILE FLOW Renal Artery Obstruction WALL SHEAR-STRESS Prosthesis Design Renal Circulation Blood Vessel Prosthesis Implantation 03 medical and health sciences Aneurysm Blood vessel prosthesis medicine.artery medicine Humans Renal artery ABDOMINAL AORTIC-ANEURYSM CONSEQUENCES business.industry FLUID-DYNAMICS IN-VITRO medicine.disease Blood Vessel Prosthesis ATHEROSCLEROSIS 2023 OA procedure Surgery Stress Mechanical business Aortic Aneurysm Abdominal |
| Zdroj: | Journal of Vascular Surgery, 67(5), 1585-1594. MOSBY-ELSEVIER Journal of vascular surgery, 67(5), 1585-1594. Elsevier |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2017.05.092 |
| Popis: | Objective: To achieve an optimal sealing zone during endovascular aneurysm repair, the intended positioning of the proximal end of the endograft fabric should be as close as possible to the most caudal edge of the renal arteries. Some endografts exhibit a small offset between the radiopaque markers and the proximal fabric edge. Unintended partial renal artery coverage may thus occur. This study investigated the consequences of partial coverage on renal flow patterns and wall shear stress (WSS). Methods: In vitro models of an abdominal aortic aneurysm were used to visualize pulsatile flow using two-dimensional particle image velocimetry under physiologic resting conditions. One model served as control and two models were stented with an Endurant endograft (Medtronic Inc, Minneapolis, Minn), one without and one with partial renal artery coverage with 1.3 mm of stent fabric extending beyond the marker (16% area coverage). The magnitude and oscillation of WSS, relative residence time, and backflow in the renal artery were analyzed. Results: In both stented models, a region along the caudal renal artery wall presented with low and oscillating WSS, not present in the control model. A region with very low WSS ( |
| Databáze: | OpenAIRE |
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