Experimental Analysis of Pressure and Flow Alterations During and After Insertion of a Multilayer Flow Modulator into an AAA Model with Incorporated Branch
Experimental Analysis of Pressure and Flow Alterations During and After Insertion of a Multilayer Flow Modulator into an AAA Model with Incorporated Branch
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将多层流量调节器插入具有合并分支的 AAA 模型期间和之后压力和流量变化的实验分析
DOI：
10.1007/s00270-021-02835-z
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Makoto Ohta
中科院分区：
文献类型：
--
作者：
Simon TUPIN;Kei Takase;Makoto Ohta
目的多层血流调节器（MFM）用于腹主动脉瘤（AAA）的治疗已有十多年的历史。尽管已经发表了几项临床研究，但由于尚未进行描述其机制的定量分析，因此对该装置功效的批评和担忧仍然存在。本研究的目的是实验评估MFM装置部署对动脉瘤压力和分支灌注的影响。材料和方法：开发了一个实验流量和压力监测系统，分析由合格的放射科医生在有和没有侧分支的AAA几何形状中执行的MFM部署程序。然后对有和没有MFM装置的模型进行颗粒图像测速实验，评估和比较动脉瘤内的流动模式和局部流速和涡量。结果实验结果显示，在MFM装置部署期间和部署后，压力和流量没有明显变化。合并分支的流速被完全保留。在两种模型中，动脉瘤血流速度均显著降低。此外，该装置改变了局部流动模式，降低了涡度，更好地馈送了并入的分支。结论本实验研究为更好地理解MFM装置的机制提供了基础，MFM装置可以减少动脉瘤内流量，同时保留合并分支流量，降低II型内漏的风险。为本研究开发的实验系统在模拟血管内手术和研究血管内装置的安全性和有效性方面是有效的。
PurposeThe multilayer flow modulator (MFM) device has been used for the treatment of abdominal aortic aneurysm (AAA) for over a decade. Although several clinical studies have been published, criticism and concern over the device efficacy remain, as no quantitative analysis that describes its mechanism has been performed yet. The aim of this study was to experimentally evaluate the effect of MFM device deployment on aneurysmal pressure and branch perfusion.Materials and MethodsAn experimental flow and pressure monitoring system was developed to analyze the MFM deployment procedure performed by a qualified radiologist in AAA geometries with and without side branch. Particle image velocimetry experiments were then conducted on models with and without MFM device to evaluate and compare flow patterns and local flow velocity and vorticity in the aneurysm.ResultsThe experiments revealed no significant change in pressure and flow rate during and after deployment of the MFM device. The flow rate of the incorporated branch was fully preserved. On both models, the aneurysmal flow velocity was significantly reduced. In addition, the device modified local flow patterns, reducing vorticity and better feeding the incorporated branch.ConclusionThis experimental study provides the basis for a better understanding of the mechanism of the MFM device, which allows intra-aneurysmal flow to decrease while preserving incorporated branch flow and reducing the risk of type II endoleak. The experimental system developed for this study was effective in simulating an endovascular procedure and studying the safety and effectiveness of endovascular devices.
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