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球囊扩张式冠状动脉支架的计算流体动力学分析:支架与血管变形的影响

Computational fluid dynamics analysis of balloon-expandable coronary stents: influence of stent and vessel deformation.

作者信息

Martin David M, Murphy Eoin A, Boyle Fergal J

机构信息

Department of Mechanical Engineering, Dublin Institute of Technology, Bolton Street, Dublin 1, Ireland.

Department of Mechanical Engineering, Dublin Institute of Technology, Bolton Street, Dublin 1, Ireland.

出版信息

Med Eng Phys. 2014 Aug;36(8):1047-56. doi: 10.1016/j.medengphy.2014.05.011. Epub 2014 Jun 20.

Abstract

In many computational fluid dynamics (CFD) studies of stented vessel haemodynamics, the geometry of the stented vessel is described using non-deformed (NDF) geometrical models. These NDF models neglect complex physical features, such as stent and vessel deformation, which may have a major impact on the haemodynamic environment in stented coronary arteries. In this study, CFD analyses were carried out to simulate pulsatile flow conditions in both NDF and realistically-deformed (RDF) models of three stented coronary arteries. While the NDF models were completely idealised, the RDF models were obtained from nonlinear structural analyses and accounted for both stent and vessel deformation. Following the completion of the CFD analyses, major differences were observed in the time-averaged wall shear stress (TAWSS), time-averaged wall shear stress gradient (TAWSSG) and oscillatory shear index (OSI) distributions predicted on the luminal surface of the artery for the NDF and RDF models. Specifically, the inclusion of stent and vessel deformation in the CFD analyses resulted in a 32%, 30% and 31% increase in the area-weighted mean TAWSS, a 3%, 7% and 16% increase in the area-weighted mean TAWSSG and a 21%, 13% and 21% decrease in the area-weighted mean OSI for Stents A, B and C, respectively. These results suggest that stent and vessel deformation are likely to have a major impact on the haemodynamic environment in stented coronary arteries. In light of this observation, it is recommended that these features are considered in future CFD studies of stented vessel haemodynamics.

摘要

在许多关于植入支架血管血流动力学的计算流体动力学(CFD)研究中,植入支架血管的几何形状是使用未变形(NDF)几何模型来描述的。这些NDF模型忽略了复杂的物理特征,如支架和血管变形,而这些特征可能对植入支架的冠状动脉内的血流动力学环境产生重大影响。在本研究中,进行了CFD分析,以模拟三条植入支架冠状动脉的NDF模型和实际变形(RDF)模型中的脉动流条件。虽然NDF模型完全理想化,但RDF模型是通过非线性结构分析获得的,并且考虑了支架和血管变形。在CFD分析完成后,观察到NDF模型和RDF模型在动脉腔表面预测的时间平均壁面切应力(TAWSS)、时间平均壁面切应力梯度(TAWSSG)和振荡切变指数(OSI)分布上存在重大差异。具体而言,在CFD分析中纳入支架和血管变形后,支架A、B和C的面积加权平均TAWSS分别增加了32%、30%和31%,面积加权平均TAWSSG分别增加了3%、7%和16%,面积加权平均OSI分别降低了21%、13%和21%。这些结果表明,支架和血管变形可能对植入支架的冠状动脉内的血流动力学环境产生重大影响。鉴于这一观察结果,建议在未来关于植入支架血管血流动力学的CFD研究中考虑这些特征。

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