Precise plan of hybrid treatment for thoracoabdominal aortic aneurysm: Hemodynamics of retrograde reconstruction visceral arteries from the iliac artery.
Precise plan of hybrid treatment for thoracoabdominal aortic aneurysm: Hemodynamics of retrograde reconstruction visceral arteries from the iliac artery.
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胸腹主动脉瘤混合治疗精准方案：髂动脉逆行重建内脏动脉的血流动力学
DOI：
10.1371/journal.pone.0205679
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Zheng T
中科院分区：
文献类型：
--
作者：
Yuan D;Wen J;Peng L;Zhao J;Zheng T
混合内脏-肾去分支手术和腔内修复术已被提议作为传统胸腹主动脉瘤或夹层（TAAA或TAAD）手术的微创替代方案。到目前为止，还没有关于逆行内脏重建（RVR）对接受混合治疗的Crawford II/III/IV型TAAA患者的血流动力学影响的信息。目的是提供对单侧或双侧髂总动脉（CIA）RVR异常血流动力学的见解。从单侧CIA或双侧CIA产生理想化的三维AAs与RVR，并进行计算机模拟。结果表明，与健康AA相比，CIA的RVR导致流向内脏器官的流量急剧减少，吻合区域对移植物闭塞和动脉瘤的发生最危险。此外，与四分叉移植物相比，采用双侧双分叉移植物在壁面切应力（WSS）和流场方面具有更好的性能，但导致流向腹腔动脉和肠系膜动脉的流量较少。本研究揭示了RVR手术后的潜在风险，并指出了血管外科医生尚未充分认识到的不同内脏重建方法的优缺点。根据我们的研究结果，当CIA是内脏重建的唯一流入部位时，建议TAAA患者使用双侧双分叉移植物。将针对TAAA或TAAD设计患者特定的精确计划，以获得更好的长期结局。
Hybrid visceral-renal debranching procedures with endovascular repair have been proposed as a less invasive alternative to conventional thoracoabdominal aortic aneurysm or dissection (TAAA or TAAD) surgery. Up to now, there has been no information about the hemodynamic effects of retrograde visceral reconstruction (RVR) for Crawford type II/III/IV TAAA patients undergoing hybrid treatment. The aim is to provide insights in the abnormal hemodynamics of RVR from unilateral or bilateral common iliac arteries (CIAs). Idealized three-dimensional AAs with RVR from unilateral CIA or bilateral CIAs were generated and computationally simulated. The results show that RVRs from CIA lead to a dramatic decrease in flow to the visceral organs compared with a healthy AA and that the anastomosis region is most dangerous to graft occlusion and the initiation of an aneurysm. In addition, compared with a quar-furcated graft, the employment of bilateral bi-furcated grafts have better performance in terms of the wall shear stress (WSS) and flow filed but result in less flow to the celiac and mesenteric arteries. This study has revealed the potential risks after an RVR operation, and points out the advantages and disadvantages of different approaches for the visceral reconstruction, which the vascular surgeons are not fully aware of. According to our results, bilateral bi-furcated grafts are recommended to the TAAA patients when the CIAs are unique inflow sites for visceral reconstruction. A precise plan with patient specific for TAAA or TAAD will be designed for better long-term outcome.
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影响因子：
39.3
作者：
Erbel, Raimund;Aboyans, Victor;Vrints, Christiaan J. M.
通讯作者：
Vrints, Christiaan J. M.
DOI：
10.1161/01.atv.0000229658.76797.30
发表时间：
2006-08-01
影响因子：
8.7
作者：
Hathcock, James J.
通讯作者：
Hathcock, James J.
影响因子：
8.3
作者：
Boussel L;Rayz V;McCulloch C;Martin A;Acevedo-Bolton G;Lawton M;Higashida R;Smith WS;Young WL;Saloner D
通讯作者：
Saloner D
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。
影响因子：
4.6
作者：
Wen J;Yuan D;Wang Q;Hu Y;Zhao J;Zheng T;Fan Y
通讯作者：
Fan Y
影响因子：
3.9
作者：
Coppola, G.;Caro, C.
通讯作者：
Caro, C.