Evaluation of the hemodynamic effectiveness of aortic dissection treatments via virtual stenting.
Evaluation of the hemodynamic effectiveness of aortic dissection treatments via virtual stenting.
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DOI：
10.5301/ijao.5000310
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发表时间：
2014-10-01
期刊：
影响因子：
--
通讯作者：
Diaz-Zuccarini, Vanessa
中科院分区：
文献类型：
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作者：
Alimohammadi, Mona;Bhattacharya-Ghosh, Benjamin;Diaz-Zuccarini, Vanessa
主动脉夹层的治疗因患者而异，支架植入术是用于稳定病情的多种方法之一。关于夹层和虚拟支架植入病例中主动脉血流动力学力的信息可以支持临床医生在医疗干预前选择治疗。计算流体动力学与集总参数模型相结合，在提供可用于临床的详细信息方面显示出了希望;为此，有必要开发个性化的工作流程，以产生患者特定的模拟。在本研究中，研究了主动脉夹层支架植入前和支架植入后（虚拟覆膜支架）的病例，特别关注个性化边界条件的作用。对于每个虚拟的情况下，速度，压力，能量损失和壁面剪应力值进行评估和比较。模拟单枚覆膜支架仅略微降低了脉压和全身能量损失。双覆膜支架的结果显示，脉压降低幅度更大，能量损失减少40%，壁面剪应力分布更符合生理学，并突出显示了潜在风险区域。本研究中应用的方法揭示了两种可能的手术结果病例的详细信息，并显示出作为诊断和介入工具的前景。
Aortic dissection treatment varies for each patient and stenting is one of a number of approaches that are utilized to Stabilize the condition. Information regarding the hemodynamic forces in the aorta in dissected and virtually stented cases could support clinicians in their choices of treatment prior to medical intervention. Computational fluid dynamics coupled with lumped parameter models have shown promise in providing detailed information that could be used in the clinic; for this, it is necessary to develop personalized workflows in order to produce patient-specific simulations. In the present study, a case of pre- and post-stenting (virtual stent-graft) of an aortic dissection is investigated with a particular focus on the role of personalized boundary conditions. For each virtual case, velocity, pressure, energy loss, and wall shear stress values are evaluated and compared. The simulated single stent-graft only marginally reduced the pulse pressure and systemic energy loss. The double stent-graft results showed a larger reduction in pulse pressure and a 40% reduction in energy loss as well as a more physiological wall shear stress distribution.Regions of potential risk were highlighted. The methodology applied in the present study revealed detailed information about two possible surgical outcome cases and shows promise as both a diagnostic and an interventional tool.