Computational Fluid Dynamics Modeling of Proximal Landing Zones for Thoracic Endovascular Aortic Repair in the Bovine Arch Variant.
Aged
Aged, 80 and over
Aorta, Thoracic
/ diagnostic imaging
Aortography
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
/ instrumentation
Computed Tomography Angiography
Computer Simulation
Endovascular Procedures
/ instrumentation
Female
Hemodynamics
Humans
Hydrodynamics
Male
Models, Cardiovascular
Pulsatile Flow
Retrospective Studies
Stress, Mechanical
Journal
Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
26
03
2020
revised:
17
04
2020
accepted:
08
05
2020
pubmed:
2
6
2020
medline:
1
12
2020
entrez:
2
6
2020
Statut:
ppublish
Résumé
To assess the endograft displacement forces (DF), which quantify the forces exerted by the pulsatile blood flow on the vessel wall and transmitted on the terminal fixation site of the endograft after its deployment in proximal landing zones (PLZs) of the bovine aortic arch variant. Thirty healthy aortic computed tomographic angiographies of subjects with bovine arch configuration (10 per type of arch, I-III) were selected for the purpose of the study. A 3-dimensional model of the aortic arch lumen was reconstructed. Computational fluid dynamics modeling was then used to compute DF magnitude and orientation (i.e., x, y, and z axes) in PLZs of each case. DF values were normalized to the corresponding aortic wall area to estimate equivalent surface traction (EST). DF were highest in zone 0, consistently with the greater surface area. DF in zone 3 were much greater than in zone 2 because of a 3-fold greater upward component (z axis) (P < 0.001), being therefore mainly oriented orthogonally to the aortic blood flow and to the vessel longitudinal axis in that zone. EST progressively increased from zone 0 toward more distal PLZs, with EST in zone 3 being much greater than that in zone 2 (P < 0.001). The same pattern was observed after stratification by type of arch. The bovine arch is associated with a consistent fluid dynamic pattern, which identifies in zone 3 an unfavorable biomechanical environment for endograft deployment.
Sections du résumé
BACKGROUND
BACKGROUND
To assess the endograft displacement forces (DF), which quantify the forces exerted by the pulsatile blood flow on the vessel wall and transmitted on the terminal fixation site of the endograft after its deployment in proximal landing zones (PLZs) of the bovine aortic arch variant.
METHODS
METHODS
Thirty healthy aortic computed tomographic angiographies of subjects with bovine arch configuration (10 per type of arch, I-III) were selected for the purpose of the study. A 3-dimensional model of the aortic arch lumen was reconstructed. Computational fluid dynamics modeling was then used to compute DF magnitude and orientation (i.e., x, y, and z axes) in PLZs of each case. DF values were normalized to the corresponding aortic wall area to estimate equivalent surface traction (EST).
RESULTS
RESULTS
DF were highest in zone 0, consistently with the greater surface area. DF in zone 3 were much greater than in zone 2 because of a 3-fold greater upward component (z axis) (P < 0.001), being therefore mainly oriented orthogonally to the aortic blood flow and to the vessel longitudinal axis in that zone. EST progressively increased from zone 0 toward more distal PLZs, with EST in zone 3 being much greater than that in zone 2 (P < 0.001). The same pattern was observed after stratification by type of arch.
CONCLUSIONS
CONCLUSIONS
The bovine arch is associated with a consistent fluid dynamic pattern, which identifies in zone 3 an unfavorable biomechanical environment for endograft deployment.
Identifiants
pubmed: 32479874
pii: S0890-5096(20)30431-3
doi: 10.1016/j.avsg.2020.05.024
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
413-417Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.