Hemodynamic effects of stent-graft introducer sheath during thoracic endovascular aortic repair
| Autor: | Yonghui Qiao, Le Mao, Yan Wang, Jingyang Luan, Yanlu Chen, Ting Zhu, Kun Luo, Jianren Fan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Aortic Aneurysm
Thoracic Mechanical Engineering Endovascular Procedures Hemodynamics Fluid Dynamics (physics.flu-dyn) FOS: Physical sciences Aorta Thoracic Physics - Fluid Dynamics Prosthesis Design Physics - Medical Physics Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation Treatment Outcome Modeling and Simulation cardiovascular system Humans Stents Medical Physics (physics.med-ph) Biotechnology |
| Popis: | Thoracic endovascular aortic repair (TEVAR) has become the standard treatment of a variety of aortic pathologies. The objective of this study is to evaluate the hemodynamic effects of stent-graft introducer sheath during TEVAR. Three idealized representative diseased aortas of aortic aneurysm, coarctation of the aorta, and aortic dissection were designed. Computational fluid dynamics studies were performed in the above idealized aortic geometries. An introducer sheath routinely used in the clinic was virtually-delivered into diseased aortas. Comparative analysis was carried out to evaluate the hemodynamic effects of the introducer sheath. Results show that the blood flow to the supra-aortic branches would increase above 9% due to the obstruction of the introducer sheath. The region exposed to high endothelial cell activation potential (ECAP) expands in the scenarios of coarctation of the aorta and aortic dissection, which indicates that the probability of thrombus formation may increase during TEVAR. The pressure magnitude in peak systole shows an obvious rise and a similar phenomenon is not observed in early diastole. The blood viscosity in the aortic arch and descending aorta is remarkably altered by the introducer sheath. The uneven viscosity distribution confirms the necessity of using non-Newtonian models and high viscosity region with high ECAP further promotes thrombosis. Our results highlight the hemodynamic effects of stent-graft introducer sheath during TEVAR, which may associate with perioperative complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|