High Wall Stress May Predict the Formation of Stent-Graft-Induced New Entries After Thoracic Endovascular Aortic Repair
High Wall Stress May Predict the Formation of Stent-Graft-Induced New Entries After Thoracic Endovascular Aortic Repair
复制标题
高壁应力可以预测支架移植物的形成——胸主动脉腔内修复术后诱导的新入口
DOI：
10.1177/1526602818791827
复制
发表时间：
2018-10-01
影响因子：
2.6
通讯作者：
Xu, Xiao Yun
中科院分区：
文献类型：
--
作者：
Menichini, Claudia;Pirola, Selene;Xu, Xiao Yun
目的：探讨形态因素和壁应力在胸主动脉腔内修补术(TEVAR)后基于CT图像的支架移植物新入路(SINE)形成中的潜在作用。病例报告：2例女性患者，年龄分别为59岁(1例)和44岁(2例)，在慢性期(1例)或亚急性期(2例)接受了B型夹层的TEVAR治疗。术后3个月的CT扫描显示两位患者均有不同程度的假性管腔血栓形成。在14个月的随访中，1例患者观察到正弦，而另1例患者的主动脉夹层保持稳定。根据首次随访的CT图像进行形态和有限元分析。计算结果表明，正弦型患者的支架-移植物弯曲度高于非正弦型患者，且在远端正弦型患者的壁应力明显高于非正弦型患者。结论：该病例研究提示，支架-移植物的高弯曲度可导致高的壁应力，这可能与正弦的形成有关。需要进一步的大规模人口研究来证实这一初步发现。
Purpose: To explore the potential role of morphological factors and wall stress in the formation of stent-graft-induced new entries (SINE) based on computed tomography (CT) images after thoracic endovascular aortic repair (TEVAR). Case Report: Two female patients aged 59 years (patient 1) and 44 years (patient 2) underwent TEVAR for type B dissection in the chronic (patient 1) or subacute (patient 2) phase. CT scans at 3-month follow-up showed varying degrees of false lumen thrombosis in both patients. At 14-month follow-up, a SINE was observed in patient 1 while the dissected aorta in the other patient remained stable. Morphological and finite element analyses were performed based on the first follow-up CT images. The computational results showed that the SINE patient had higher stent-graft tortuosity than the non-SINE patient and much higher wall stress in the region close to the distal SINE. Conclusion: This case study suggests that high stent-graft tortuosity can lead to high wall stress, which is potentially linked to the formation of SINE. Further large population-based studies are needed to confirm this preliminary finding.