Flow analysis of aortic dissection: comparison of inflow boundary conditions for computational models based on 4D PCMRI and Doppler ultrasound

Li, Zhenfeng; Liang, Shichao; Xu, Huanming; Zhu, Min–Sheng; Mei, Yuqian; Xiong, Jiang; Chen, Duanduan

doi:10.1080/10255842.2021.1876036

Cited by 13 publications

(11 citation statements)

References 26 publications

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“…In this region, flow jets through the PET and impinges on the wall. While differences in TAWSS and helicity were observed in the region surrounding section α , as reported in previous studies 1,24 , these conditions were not as sensitive to IVP. The contrasting haemodynamic conditions in each of these growth-prone regions suggest that FL growth may be driven by a range of different conditions.…”

Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 80%

“…Inlet conditions are known to strongly influence velocity, helicity and WSS in the ascending aorta and arch 28,25,46,1,32 and our results firmly corroborate these findings. However, the descending aorta is of greater interest in TBAD, where inlet conditions have been reported to affect qualitative distributions of TAWSS and velocity in the region immediately surrounding the PET whilst minimally affecting distal regions 1,24 . With qualitative assessment alone, our results would provide similar conclusions; velocity magnitude contours and TAWSS distributions appear qualitatively similar throughout the descending aorta.…”

Section: Discussionmentioning

confidence: 99%

“…Haemodynamic predictors extracted from 4DMR-informed CFD may assist clinicians in identifying and optimally treating these patients in future, but a more nuanced understanding of the impact of modelling assumptions, imaging errors and their combined impact on the accuracy of clinically-relevant metrics remains needed. Simulated helicity and osillatory shear have been shown to exhibit greater sensitivity to inlet conditions than other metrics 32,28 , but have not been examined in the context of TBAD 1,24 despite links with disease progression 34 . In this work, we have closely examined the sensitivity of oscillatory shear and helicity to inlet conditions in a patient-specific TBAD case, comparing them against FL growth.…”

Section: Discussionmentioning

confidence: 99%

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Aneurysmal Growth in Type-B Aortic Dissection: Assessing the Impact of Patient-Specific Inlet Conditions on Key Haemodynamic Indices

Stokes

Lind

Haupt

et al. 2023

Preprint

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Type-B Aortic Dissection (TBAD) is cardiovascular disease in which a tear develops in the intimal layer of the descending aorta, allowing pressurised blood to delaminate the intimal and medial layers to form a true and false lumen. In medically managed patients, long-term aneurysmal dilatation of the false lumen is considered virtually inevitable and is associated with poorer disease outcomes. The pathophysiological mechanisms driving false lumen dilatation are not yet understood, though haemodynamic factors are believed to play a key role. Recent analysis via Computational Fluid Dynamics (CFD) and 4D-Flow MRI have demonstrated links between flow helicity, oscillatory wall shear stress and aneurysmal dilatation of the false lumen. In this study, we compare simulations using the gold-standard three-dimensional, three-component inlet velocity profile (3D IVP) extracted from 4DMR data with flow-matched flat and through-plane profiles that remain widely used in the absence of 4DMR. Furthermore, we assess the impact of 4DMR imaging errors on the flow solution by scaling the 3D IVP components to the degree of imaging error observed in previous studies. We demonstrate that secondary inlet flows affect the distribution of oscillatory shear and helicity throughout the FL, and that even the 3D IVP exhibited notable differences in helicity and oscillatory shear when modulated to account for imaging errors. These results illustrate that the quality of inlet velocity conditions in simulations of TBAD may greatly affect their clinical value, and efforts to further enhance their patient-specific accuracy are warranted.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Aneurysmal Growth in Type-B Aortic Dissection: Assessing the Impact of Patient-Specific Inlet Conditions on Key Haemodynamic Indices

Stokes

Lind

Haupt

et al. 2023

Preprint

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“…Details of pulsatile waveforms of pressure at the celiac artery, superior mesenteric artery, renal arteries and outlets at iliac arteries were obtained from a previous study and used as pressure boundaries ( 11 ). In our previous study ( 12 ), measured pressure was compared with the data we used in this study, confirming the rationality of pressure boundary conditions.…”

Section: Methodssupporting

confidence: 75%

Functional Evaluation of Embedded Modular Single-Branched Stent Graft: Application to Type B Aortic Dissection With Aberrant Right Subclavian Artery

Zhang

Chen

Wu³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundEndovascular repair of type B aortic dissection (TBAD) with aberrant right subclavian artery (ARSA) is challenging due to anatomical complexity. The embedded modular single-branched stent graft (EMSBSG) could solve this problem. However, the hemodynamic efficacy of this innovative technique has not been fully assessed. This study aimed to propose morphometric and functional indicators to quantify the outcomes of EMSBSG in treating TBAD with ARSA.Material and MethodsA patient who had TBAD with ARSA underwent EMSBSG implantation was admitted. Computational fluid dynamics (CFD) and three-dimensional structural analyses were conducted based on CTA datasets before the operation (Pre-1) and at 4 and 25 days after EMSBSG implantation (Post-1 and Post-2). Quantitative and qualitative functional analyses were conducted via pressure-, velocity- and wall shear stress (WSS) -based parameters, such as the luminal pressure difference (LPD), total energy loss, and flow distribution ratio. By precisely registering the aortas at the three time points, parameter variations in the EMSBSG region were also computed to investigate the prognostic improvement after EMSBSG implantation.ResultsThe first balance point of LPD distally shifted to the abdominal aorta in Post-1 by a distance of 20.172 cm, and shifted out of the dissected region in Post-2, indicating positive pressure recovery post EMSBSG. The flow distribution ratios of all aortic arch branches increased after EMSBSG implantation. A positive normal deformation index in the EMSBSG region confirmed true lumen expansion; dominant ARN (area ratio of negative value) of pressure and WSS-based parameters indicated an improved prognosis from Post-1 to Post-2.ConclusionsThe short-term results of EMSBSG in treating TBAD with ARSA proved to be promising, especially in EMSBSG region. Comprehensive evaluation could provide new insight into the therapy of TBAD with ARSA. Thus, it might guide the further management of complex aortic arch lesions.

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Hemodynamic effects of stent-graft introducer sheath during thoracic endovascular aortic repair

Qiao

Mao

Wang

et al. 2022

Biomech Model Mechanobiol

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Flow analysis of aortic dissection: comparison of inflow boundary conditions for computational models based on 4D PCMRI and Doppler ultrasound

Cited by 13 publications

References 26 publications

Aneurysmal Growth in Type-B Aortic Dissection: Assessing the Impact of Patient-Specific Inlet Conditions on Key Haemodynamic Indices

Aneurysmal Growth in Type-B Aortic Dissection: Assessing the Impact of Patient-Specific Inlet Conditions on Key Haemodynamic Indices

Functional Evaluation of Embedded Modular Single-Branched Stent Graft: Application to Type B Aortic Dissection With Aberrant Right Subclavian Artery

Hemodynamic effects of stent-graft introducer sheath during thoracic endovascular aortic repair

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