Spatial Configuration of Abdominal Aortic Aneurysm Analysis as a Useful Tool for the Estimation of Stent-Graft Migration

Polańczyk, Andrzej; Piechota-Polańczyk, Aleksandra; Stefańczyk, Ludomir; Strzelecki, Michał

doi:10.3390/diagnostics10100737

Cited by 6 publications

(4 citation statements)

References 48 publications

(50 reference statements)

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“…Therefore, only thorough analysis of vast number of cases, will allow to identify outliers and take into account their specificity. According to this, we assume that the methodology proposed in this study is correct, and is in agreement with our previous data [16,22]. Limitation to the study The benefits of CFD must be viewed in the context of known limitations of this approach.…”

Section: Discussionsupporting

confidence: 81%

“…The current in-hospital mortality rates remain significant, at the level of approximately 10% [15]. For this reason, computational cardiovascular mechanics has allowed scientists to create complex 3D models for the simulation of cardiovascular pathologies [16]. Therefore, numerical methods for solving issues related to blood flow in vessels are widely applied [17].…”

Section: Introductionmentioning

confidence: 99%

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Computational Fluid Dynamics as an Engineering Tool for the Reconstruction of Endovascular Prosthesis Endoleaks

et al. 2022

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Background and objectives: Endovascular prosthesis placement is a predominant surgical procedure to reduce the risk of aneurysm rupture in abdominal aortic aneurysm patients. The formation of an endoleak is a major complication of stent-graft placement. Therefore, the aim of this study was to determine the influence of stent-graft's spatial configuration on the risk of leakage under realistic flow conditions. Materials and Methods: We analyzed data collected from 10 male patients 55±3 years old after CTA who had undergone endovascular treatment. Computational Fluid Dynamics technique was applied for the reconstruction of blood hemodynamic. Two cases of the stent-graft were analyzed each time, with and without the endoleak, reconstructed from one patient data with the endoleak. Endoleak-free geometries were prepared by virtual closure of the opening. Results: It was observed that high value of the blood velocity around the endoleak may provoke its slowly rupture, which may increase the blood flow to the aneurysm sack in the case of type II endoleaks. Moreover, the appearance of endoleak reduces the average blood velocity in the entire stent-graft which in some cases may contribute to blood coagulation. Furthermore, no clot can form at the site of the endoleak due to the high value of wall shear stress near of the endoleak which prevents thrombosis.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Computational Fluid Dynamics as an Engineering Tool for the Reconstruction of Endovascular Prosthesis Endoleaks

et al. 2022

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“…Increased conduit stiffness elevates pulse wave velocity, leading to increased pulse pressure ( 22 – 24 ), thus resulting in adverse cardiac remodeling ( 25 , 26 ). Moreover, flow acceleration could potentially indicate the risk of stent graft migration ( 27 , 28 ). This information informed us to monitor high flow and pressure patterns after EMSBSG treatment.…”

Section: Discussionmentioning

confidence: 99%

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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“…The current in-hospital mortality rates remain significant, with reported mortality rates of approximately 10% [11]. For this reason, computational cardiovascular mechanics has allowed scientists to create complex 3D models for the simulation of cardiovascular problems [12]. The application of the computational fluid dynamic (CFD) technique in the topic of blood hemodynamic in vessels is widely described in the literature [13,14].…”

Section: Introductionmentioning

confidence: 99%

Computational Fluid Dynamic Technique for Assessment of How Changing Character of Blood Flow and Different Value of Hct Influence Blood Hemodynamic in Dissected Aorta

et al. 2021

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Using computer tomography angiography (CTA) and computational structural analysis, we present a non-invasive method of mass flow rate/velocity and wall stress analysis in type B aortic dissection. Three-dimensional (3D) computer models of the aorta were calculated using pre-operative (baseline) and post-operative CT data from 12 male patients (aged from 51 to 64 years) who were treated for acute type B dissection. A computational fluid dynamics (CFD) technique was used to quantify the displacement forces acting on the aortic wall in the areas of endografts placement. The mass flow rate and wall stress were measured and quantified using the CFD technique. The CFD model indicated the places with a lower value of blood velocity and shear rate, which corelated with higher blood viscosity and a probability of thrombus appearance. Moreover, with the increase in Hct, blood viscosity also increased, while the intensity of blood flow provoked changing viscosity values in these areas. Furthermore, the velocity gradient near the tear surface caused high wall WSS; this could lead to a decreased resistance in the aorta’s wall with further implications to a patient.

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Spatial Configuration of Abdominal Aortic Aneurysm Analysis as a Useful Tool for the Estimation of Stent-Graft Migration

Cited by 6 publications

References 48 publications

Computational Fluid Dynamics as an Engineering Tool for the Reconstruction of Endovascular Prosthesis Endoleaks

Computational Fluid Dynamics as an Engineering Tool for the Reconstruction of Endovascular Prosthesis Endoleaks

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

Computational Fluid Dynamic Technique for Assessment of How Changing Character of Blood Flow and Different Value of Hct Influence Blood Hemodynamic in Dissected Aorta

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