The Modified Arch Landing Areas Nomenclature (MALAN) Improves Prediction of Stent Graft Displacement Forces: Proof of Concept by Computational Fluid Dynamics Modelling
The Modified Arch Landing Areas Nomenclature (MALAN) Improves Prediction of Stent Graft Displacement Forces: Proof of Concept by Computational Fluid Dynamics Modelling
复制标题
DOI：
10.1016/j.ejvs.2017.12.019
复制
发表时间：
2018-04-01
影响因子：
5.7
通讯作者：
Trimarchi, Santi
中科院分区：
文献类型：
--
作者：
Marrocco-Trischitta, Massimiliano M.;van Bakel, Theodorus M.;Trimarchi, Santi
目的：评价将Ishimaru图谱与主动脉弓分类相结合的改良弓着落区命名法（MALAN）是否能预测TEVAR近端着落区的位移力大小及其方向。方法：采用计算流体力学（CFD）模型对假设进行验证。根据主动脉弓几何形状选择健康主动脉CT血管造影扫描，平均反映I型至III型弓（每个n = 5）。cfd用于计算沿Ishimaru在每个主动脉着陆区的脉动位移力，包括沿向上分量和侧向分量的三维方向。将值归一化到相应的主动脉壁面积，以计算等效表面牵引力（EST）。结果：在I型和II型弓中，EST在近端着陆区没有变化（p =.297和p =.054），而在III型弓中，EST在远端着陆区增加（p =.019）。3/II区EST大于2/II区（p = 0.016）， 3/III区EST大于2/III区（p = 0.016）。值得注意的是，这些差异与向上部分有关，3/II的向上部分是2/II的四倍(p
Objective: To assess whether the Modified Arch Landing Areas Nomenclature (MALAN), which merges Ishimaru's map with the Aortic Arch Classification, predicts the magnitude of displacement forces and their orientation in proximal landing zones for TEVAR.Methods: Computational fluid dynamic (CFD) modelling was employed to prove the hypothesis. Healthy aorta CT angiography scans were selected based on aortic arch geometry to reflect Types I to III arches equally (each n = 5). CFDs were used to compute pulsatile displacement forces along the Ishimaru's landing zones in each aorta including their three dimensional orientation along the upward component and sideways component. Values were normalised to the corresponding aortic wall area to calculate equivalent surface traction (EST).Results: In Types I and II arches, EST did not change across proximal landing zones (p =.297 and p =.054, respectively), whereas in Type III, EST increased towards more distal landing zones (p =.019). Comparison of EST between adjacent zones, however, showed that EST was greater in 3/II than in 2/II (p =.016), and in 3/III than in 2/III (p =.016). Notably, these differences were related to the upward component, that was four times greater in 3/II compared with 2/II (p