A computational simulation of the effect of hybrid treatment for thoracoabdominal aortic aneurysm on the hemodynamics of abdominal aorta.
A computational simulation of the effect of hybrid treatment for thoracoabdominal aortic aneurysm on the hemodynamics of abdominal aorta.
复制标题
杂交治疗对胸腔主动脉瘤对腹主动脉血流动力学的影响的计算模拟。
DOI：
10.1038/srep23801
复制
发表时间：
2016-03-31
影响因子：
4.6
通讯作者：
Fan Y
中科院分区：
文献类型：
--
作者：
Wen J;Yuan D;Wang Q;Hu Y;Zhao J;Zheng T;Fan Y
混合内脏-肾去分支手术和腔内修复术已被提议作为治疗传统胸腹主动脉瘤（TAAA）的一种有吸引力的技术。然而，这种方法仍然存在争议，因为其逆行内脏血运重建（RVR）的非生理性血流方向，通常从主动脉分叉或髂总动脉构建。本文通过数值模拟研究了RVR对腹主动脉血流动力学的影响。结果表明，RVR的流入部位对血流动力学性能有很大影响。当RVR来自远端主动脉时，内脏器官的灌注充足，但髂动脉的流量显著减少，并且在远端主动脉处形成复杂的扰动流场，这危及动脉瘤发展的高风险主动脉。当RVR来自右髂动脉时，腹主动脉无低WSS或血流紊乱，但内脏器官灌注不足达40%，右髂动脉和移植物主要出现低WSS和流速，这可能导致移植物狭窄和宿主髂动脉瘤生长。
Hybrid visceral-renal debranching procedures with endovascular repair have been proposed as an appealing technique to treat conventional thoracoabdominal aortic aneurysm (TAAA). This approach, however, still remained controversial because of the non-physiological blood flow direction of its retrograde visceral revascularization (RVR) which is generally constructed from the aortic bifurcation or common iliac artery. The current study carried out the numerical simulation to investigate the effect of RVR on the hemodynamics of abdominal aorta. The results indicated that the inflow sites for the RVR have great impact on the hemodynamic performance. When RVR was from the distal aorta, the perfusion to visceral organs were adequate but the flow flux to the iliac artery significantly decreased and a complex disturbed flow field developed at the distal aorta, which endangered the aorta at high risk of aneurysm development. When RVR was from the right iliac artery, the abdominal aorta was not troubled with low WSS or disturbed flow, but the inadequate perfusion to the visceral organs reached up to 40% and low WSS and flow velocity predominated appeared at the right iliac artery and the grafts, which may result in the stenosis in grafts and aneurysm growth on the host iliac artery.