Wan Ab Naim Wan Naimah, Ganesan Poo Balan, Sun Zhonghua, Chee Kok Han, Hashim Shahrul Amry, Lim Einly
Department of Biomedical Engineering, Faculty of Engineering Building, University of Malaya, 50603 Kuala Lumpur, KL, Malaysia.
Department of Mechanical Engineering, Faculty of Engineering Building, University of Malaya, 50603 Kuala Lumpur, KL, Malaysia.
ScientificWorldJournal. 2014 Feb 3;2014:652520. doi: 10.1155/2014/652520. eCollection 2014.
Aortic dissection, characterized by separation of the layers of the aortic wall, poses a significant challenge for clinicians. While type A aortic dissection patients are normally managed using surgical treatment, optimal treatment strategy for type B aortic dissection remains controversial and requires further evaluation. Although aortic diameter measured by CT angiography has been clinically used as a guideline to predict dilation in aortic dissection, hemodynamic parameters (e.g., pressure and wall shear stress), geometrical factors, and composition of the aorta wall are known to substantially affect disease progression. Due to the limitations of cardiac imaging modalities, numerical simulations have been widely used for the prediction of disease progression and therapeutic outcomes, by providing detailed insights into the hemodynamics. This paper presents a comprehensive review of the existing numerical models developed to investigate reasons behind tear initiation and progression, as well as the effectiveness of various treatment strategies, particularly the stent graft treatment.
主动脉夹层是指主动脉壁各层之间的分离,这给临床医生带来了重大挑战。虽然A型主动脉夹层患者通常采用手术治疗,但B型主动脉夹层的最佳治疗策略仍存在争议,需要进一步评估。尽管CT血管造影测量的主动脉直径已在临床上用作预测主动脉夹层扩张的指导指标,但已知血流动力学参数(如压力和壁面剪应力)、几何因素和主动脉壁成分会对疾病进展产生重大影响。由于心脏成像模式的局限性,数值模拟已被广泛用于预测疾病进展和治疗结果,通过提供对血流动力学的详细洞察。本文全面综述了现有的数值模型,这些模型用于研究撕裂起始和进展背后的原因,以及各种治疗策略的有效性,特别是支架移植物治疗。