Hemodynamic conditions in a failing peripheral artery bypass graft.
Hemodynamic conditions in a failing peripheral artery bypass graft.
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DOI：
10.1016/j.jvs.2012.01.045
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发表时间：
2012-08
影响因子：
4.3
通讯作者：
Aliseda, Alberto
中科院分区：
文献类型：
--
作者：
McGah, Patrick M.;Leotta, Daniel F.;Beach, Kirk W.;Zierler, R. Eugene;Riley, James J.;Aliseda, Alberto
自体静脉旁路移植术治疗外周动脉疾病后再狭窄的机制尚不完全清楚。我们试图调查血液动力学应力的作用，在一个案例研究的修订旁路移植失败，由于再狭窄。管腔的形态从定制的3D超声系统重建。在补片血管成形术后1个月、6个月和16个月进行扫描。患者特定模型的计算血流动力学模拟提供了研究的三个时间点的血流特征和血管壁上的血流动力学应力。该血管最初没有任何可检测到的病变，但在16个月的研究间隔内出现了60%的直径缩小狭窄。正如模拟所确定的那样，由于补片位置处的管腔突然变宽，狭窄下游出现了混乱和再循环的流动。曲率和管腔横截面积的突然增加诱导了这些流动特征，这些流动特征被假设为有助于内膜增生。有利的协议之间的模拟结果和在体内多普勒超声速度测量。过渡和混乱的流动发生在该网站的修订，诱导一个复杂的模式的壁剪切计算与血液动力学模拟。这支持了这样的假设，即血管几何形状和混沌流耦合产生的翻修节段中的血流动力学应力导致了覆膜支架的内膜增生和再狭窄。
The mechanisms of restenosis in autogenous vein bypass grafts placed for peripheral artery disease are not completely understood. We seek to investigate the role of hemodynamic stress in a case study of a revised bypass graft that failed due to restenosis. The morphology of the lumen is reconstructed from a custom 3D ultrasound system. Scans were taken at one, six, and sixteen months after a patch angioplasty procedure. Computational hemodynamic simulations of the patient-specific model provide the blood flow features and the hemodynamic stresses on the vessel wall at the three time points studied. The vessel was initially free of any detectable lesions, but a 60% diameter reducing stenosis developed over the 16 month interval of study. As determined from the simulations, chaotic and recirculating flow occurred downstream of the stenosis due to the sudden widening of the lumen at the patch location. Curvature and a sudden increase in the lumen cross-sectional area induce these flow features that are hypothesized to be conducive to intimal hyperplasia. Favorable agreement was found between simulation results and in vivo Doppler ultrasound velocity measurements. Transitional and chaotic flow occurs at the site of the revision, inducing a complex pattern of wall shear are computed with the hemodynamic simulations. This supports the hypothesis that the hemodynamic stresses in the revised segment, produced by the coupling of vessel geometry and chaotic flow, led to the intimal hyperplasia and restenosis of the graft.
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影响因子：
4.3
作者：
MILLS, JL;BANDYK, DF;LOGERFO, FW
通讯作者：
LOGERFO, FW
DOI：
10.1115/1.4003622
发表时间：
2011-04-01
影响因子：
1.7
作者：
McGah, Patrick M.;Leotta, Daniel F.;Aliseda, Alberto
通讯作者：
Aliseda, Alberto
影响因子：
4.3
作者：
BASSIOUNY, HS;WHITE, S;ZARINS, CK
通讯作者：
ZARINS, CK
影响因子：
8.3
作者：
DOBRIN, PB
通讯作者：
DOBRIN, PB
影响因子：
4.3
作者：
O'Brien, TP;Grace, P;McGloughlin, T
通讯作者：
McGloughlin, T