True-lumen collapse in aortic dissection - Part I. Evaluation of causative factors in phantoms with pulsatile flow
True-lumen collapse in aortic dissection - Part I. Evaluation of causative factors in phantoms with pulsatile flow
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DOI：
10.1148/radiology.214.1.r00ja3287
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发表时间：
2000-01-01
期刊：
影响因子：
19.7
通讯作者：
Dake, MD
中科院分区：
文献类型：
--
作者：
Chung, JW;Elkins, C;Dake, MD
目得：材料与方法：采用主动脉弓、腹分支血管和远端分叉血管的真腔和假腔模型，建立斯坦福大学B型主动脉夹层模型，探讨其真腔塌陷的原因。研究了解剖学因素（入口撕裂大小、分支血管流量分布、开窗、远端折返通信）和生理学因素（分支血管中的外周阻力、泵输出和速率、血管顺应性）对真腔塌陷的影响。观察真腔形态。测量分支压力和流速。结果：真腔塌陷是由入口撕裂尺寸的增加、假腔分支血管闭塞引起的假腔流出量的减少以及真腔分支血管外周阻力降低引起的真腔流出量的增加引起的，并加剧了真腔塌陷。两种真腔塌陷取决于泵的输出。由于泵输出量低和真腔流出阻力低，真腔塌陷。假腔内泵输出量大，流入阻力小，压迫真腔。真、假肢之间的远端折返通信是更有效的比主动脉开窗术在防止真腔collaps.CONCLUSION：真腔塌陷在这种夹层模型强烈依赖于流入能力的比例，真、假腔流出能力的差异。解剖和生理因素都可以影响真腔塌陷。
PURPOSE: To investigate the causative factors in true-lumen collapse in a model of aortic dissection.MATERIALS AND METHODS: Phantoms with an aortic arch, true and false lumina with abdominal branch vessels, and a distal bifurcation were used to model a Stanford type B aortic dissection. The effects of anatomic factors (entry-tear size, branch-vessel flow distribution, fenestrations, distal reentry communication) and physiologic factors (peripheral resistance in the branch vessels, pump output and rate, vascular compliance) on true-lumen collapse were investigated. The morphology of the true lumen was observed. Branch pressures and flow rates were measured.RESULTS: True-lumen collapse was induced and was exacerbated by an increase-in the size of the entry tear, a decrease in the false-lumen outflow caused by occluding the false-lumen branch vessels, and an increase in the true-lumen outflow caused by lowering the peripheral resistance in true-lumen branch vessels.: Two kinds of true-lumen collapse depended on pump output. With low pump output and low outflow resistance from the true lumen, the true lumen collapsed. With high pump output and low inflow resistance in the false lumen, the true lumen Was compressed. Distal reentry communication between the true and false limbs was more effective than aortic fenestrations in preventing true-lumen collapse.CONCLUSION: True-lumen collapse in this dissection model strongly depends on the difference in the ratios of inflow capacity to outflow capacity in the true and false lumina. Both anatomic and physiologic factors can affect-true-lumen collapse.