Hemodynamic impact of abdominal aortic aneurysm stent-graft implantation-induced stenosis

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

The current study aims to computationally evaluate the hemodynamic impact of a novel sealing mechanism employed by a recently developed endograft (Ovation TriVascular Stent-Graft System) for endovascular aneurysm repair. The exploitation of two inflatable O-rings to achieve sealing may be advantageous in terms of accommodating challenging anatomies, but comes at a price of a marked inflow stenosis. Here, four representative patient cases of inflow stenosis ranging from 30 to 80 % were analyzed. Lumen surface models were constructed from 1 month post-operative computed tomography images and then used to numerically compute the complex endograft flow field. Our results highlight coexistence of stenotic wall regions exposed to high shear rate and post-stenotic recirculation zones. These conditions may implicate platelet activation and predispose thrombus formation and thromboembolic complications. A clinically insignificant cycle-averaged pressure drop along the inflow stenosis and further in the endograft main body legs was predicted (range 0.01–1.72 mmHg) which was, however, notable at peak systole (range 3.52–19.73 mmHg). Although the functional impact of the endograft stenosis at rest flow conditions may appear insignificant, increased flow rate during exercise is expected to strongly accentuate the observed effects. Pressure drop in the endograft legs was attributed to suboptimal, based on Murray’s scaling law, cross-sectional area ratio between trunk and legs of the device.

Detaljer

Författare
  • Nicolas Aristokleous
  • Nikolaos G. Kontopodis
  • Konstantinos Tzirakis
  • Christos V. Ioannou
  • Yannis Papaharilaou
Externa organisationer
  • Foundation for Research and Technology - Hellas
  • University of Crete Medical School
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Fysiologi

Nyckelord

Originalspråkengelska
Sidor (från-till)1523-1532
Antal sidor10
TidskriftMedical and Biological Engineering and Computing
Volym54
Utgåva nummer10
StatusPublished - 2016 okt 1
PublikationskategoriForskning
Peer review utfördJa
Externt publiceradJa