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Hemodynamic evaluation of different stent graft schemes in aortic arch covered stent implantation

Medicine in Novel Technology and Devices 2022年第1期13卷 79-86页

作者： Jingxin Liu Xinyong Cai Yuliang Zhan Hongmin Zhu Haiyong Ao Yizao Wan Honglin Luo Zhiwei Yang Quanchao Zhang Jiangxi Key Laboratory of Nanobiomaterials Institute of Advanced MaterialsEast China Jiaotong UniversityNanchang330013China Department of Cardiology Jiangxi Provincial People's Hospital Affiliated to Nanchang UniversityNanchang330006China School of Materials Science and Engineering Tianjin UniversityTianjin300072China

Implantation of the left subclavian artery(lsa)stent graft used in fenestration technique of the thoracic endovascular aortic repair(TEVAR)may interfere with the aortic helical blood flow that is believed to have important protective functions against *** present study investigated four different lsa stent graft implantation schemes for their resulted blood flow patterns in the thoracic aortic with hemodynamic computational simulation methods:the flush branch(FB),the protruding branch(PB),the straight cuff branch(SCB)and the cured cuff branch(CCB).The results showed that the PB scheme could slightly enhance helicity of the swirling flow in the aorta,but the other three schemes had less effect on blood flow *** PB scheme produced lowTAWSS,high-OSI and high-RRT around the lsa root,and the FB scheme had similar TAWSS,OSI and RRT in both value and distribution to those in the aorta without lsa stent graft *** SCB and CCB schemes led to less area of high-OSI and high-RRT values along the walls of the lsa branch *** results also showed that the PB scheme would significantly reduce blood supply to the lsa,on the contrary,the CCB scheme enhanced lsa blood supply and less effect on the total blood supply to the three branches of the thoracic *** summary,all of the four schemes have no significant effect on the aortic swirling flow,however,in the terms of TAWSS,OSI,RRT and blood supply to the lsa,the CCB model might be the best option with less area of low-WSS,high-OSI,high-RRT and well blood supply in the lsa.

关键词： Helical flow Thoracic endovascular aortic repair Fenestration technique Hemodynamic lsa stent graft

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