Numerical zero-dimensional hepatic artery hemodynamics model for balloon-occluded transarterial chemoembolization
Numerical zero-dimensional hepatic artery hemodynamics model for balloon-occluded transarterial chemoembolization
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DOI：
10.1002/cnm.2983
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发表时间：
2018-07-01
影响因子：
2.1
通讯作者：
Ignacio Bilbao, Jose
中科院分区：
文献类型：
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作者：
Aramburu, Jorge;Anton, Raul;Ignacio Bilbao, Jose
球囊闭塞肝动脉化疗栓塞术(B-TACE)对于不能手术的肝脏恶性肿瘤患者是一种有价值的治疗选择。球囊闭塞经动脉化疗栓塞术包括经导管注入抗癌药物混合物和栓塞剂。与传统的TACE不同，B-TACE是通过闭塞动脉的微球导管进行的，由于肝内外动脉的侧支循环，使得血流重新分布。最近的几项研究强调了血流重新分配在提高治疗结果方面的重要性。在本研究中，具有代表性的肝动脉和交通弓(CA)的几何形状被建模。通过对几何和边界条件的刻画，建立了在硅的零维血流动力学模型，并在体外进行了验证。通过结合2种癌症方案和2种导管位置来评估颈动脉的作用。文中还研究了铸件直径的重要性。结果表明，闭塞大动脉导致侧支循环，血管开始在血流再分配中发挥作用。总之，数值零维模拟为探索动脉闭塞引起的血流再分布提供了一种快速、可靠的方法，该方法可用于B-TACE计划。
Balloon-occluded transarterial chemoembolization (B-TACE) is a valuable treatment option for patients with inoperable malignant tumors in the liver. Balloon-occluded transarterial chemoembolization consists of the transcatheter infusion of an anticancer drug mixture and embolic agents. Contrary to conventional TACE, B-TACE is performed via an artery-occluding microballoon catheter, which makes the blood flow to redistribute due to the intra- and extrahepatic arterial collateral circulation. Several recent studies have stressed the importance of the redistribution of blood flow in enhancing the treatment outcome. In the present study, the geometries of a representative hepatic artery and the communicating arcades (CAs) are modeled. An in silico zero-dimensional hemodynamic model is created by characterizing the geometry and the boundary conditions and then is validated in vitro. The role of CAs is assessed by combining 2 cancer scenarios and 2 catheter locations. The importance of the diameter of the CAs is also studied. Results show that occluding a main artery leads to collateral circulation and CAs start to play a role in blood-flow redistribution. In summary, numerical zero-dimensional simulations permit a fast and reliable approach for exploring the blood-flow redistribution caused by the occlusion of a main artery, and this approach could be used during B-TACE planning.