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一项关于急性B型主动脉夹层支架置入术前和术后的计算流体动力学研究。

A computational fluid dynamics study pre- and post-stent graft placement in an acute type B aortic dissection.

作者信息

Karmonik Christof, Bismuth Jean, Davies Mark G, Shah Dipan J, Younes Houssam K, Lumsden Alan B

机构信息

The Methodist Hospital Neurological Institute, Houston, TX, USA.

出版信息

Vasc Endovascular Surg. 2011 Feb;45(2):157-64. doi: 10.1177/1538574410389342. Epub 2010 Dec 13.

Abstract

PURPOSE

To demonstrate the capability of computational fluid dynamics (CFD) for quantifying hemodynamic forces pretreatment/posttreatment in type B aortic dissection (TB-AD).

METHODS

From CFD simulations initialized with dynamic magnetic resonance image data, wall shear stress (WSS) and dynamic pressure (dynP) changes post endovascular treatment were quantified.

RESULTS

After 1 year follow-up, thoracic aortic segment was completely remodeled, and persistent, nonthrombosed false lumen in the abdominal aorta was noted. Pretreatment, large WSS (>5 Pa) and dynP (>80 Pa) occurred at entrance tear and a stenotic region in the true lumen (TL). Posttreatment, WSS was lower than 3.3 Pa and dynP was lower than 55 Pa in TL, except at proximal end of the stent graft and at reentrance tear. Two focal locations of high dynP existed within the stent graft.

CONCLUSIONS

Computational fluid dynamics may provide quantitative assessment of hemodynamic wall forces in TB-AD potentially of interest for follow-up examinations.

摘要

目的

证明计算流体动力学(CFD)在量化B型主动脉夹层(TB-AD)治疗前/治疗后血流动力学力方面的能力。

方法

从用动态磁共振图像数据初始化的CFD模拟中,量化血管内治疗后壁面剪应力(WSS)和动态压力(dynP)的变化。

结果

经过1年的随访,胸主动脉段完全重塑,腹主动脉中可见持续存在的、未血栓形成的假腔。治疗前,入口撕裂处和真腔(TL)的狭窄区域出现较大的WSS(>5 Pa)和dynP(>80 Pa)。治疗后,TL中的WSS低于3.3 Pa,dynP低于55 Pa,但支架移植物近端和再入口撕裂处除外。支架移植物内存在两个dynP较高的焦点位置。

结论

计算流体动力学可为TB-AD中的血流动力学壁力提供定量评估,这可能对随访检查有意义。

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