Department of Mechanical Engineering and Mechatronics, Ariel University, Israel; School of Mechanical Engineering, Tel Aviv University, Tel Aviv 69978, Israel.
Department of Mechanical Engineering and Mechatronics, Ariel University, Israel.
J Biomech. 2021 May 24;121:110351. doi: 10.1016/j.jbiomech.2021.110351. Epub 2021 Mar 19.
The aortic arch aneurysm is a complex disease that requires branching of one or more aortic arch vessels and can be fatal if left untreated. In this in vitro study, we examine the effect of the treatment approach on the unsteady hemodynamics and blood perfusion to the upper vessel's in models of an aortic arch aneurysm, and of the three common repair approaches: open-chest surgical repair, chimney, and hybrid approach. A particle image velocimetry method was used to quantify the unsteady hemodynamics in the four models simulated in a mock circulatory loop, to evaluate unsteady hemodynamic parameters and measure perfusion to the brain and the upper body. According to the findings, in terms of perfusion to the brain and upper body, the surgery model has the highest flow rate comparing to the other models in most heart-rate conditions. It also shows oscillatory parameters in the upper vessels which in normal arteries are correlated with a better arterial function. Between the two endovascular procedures, the hybrid model exhibits slightly better hemodynamic characteristics than the chimney model, with lower shear stresses and more oscillatory flow and WSS in the upper vessels. The hybrid model had lower perfusion flow rates to upper vessels during rest conditions (90BPM). However, unlike the other models, perfusion in the hybrid model increased with heart rate, thus at 135 BPM, it results in flow rate to upper vessels similar to that of the chimney model. The results of this study may shed light on future endograft' design and placement techniques.
主动脉弓动脉瘤是一种复杂的疾病，需要分支一个或多个主动脉弓血管，如果不治疗可能是致命的。在这项体外研究中，我们研究了治疗方法对主动脉弓动脉瘤模型中不稳定血流动力学和上腔血管血液灌注的影响，以及三种常见的修复方法：开胸手术修复、烟囱和杂交方法。我们使用粒子图像测速法来模拟mock circulatory loop 中的四个模型，以量化不稳定血流动力学，评估不稳定血流动力学参数并测量大脑和上半身的灌注。根据研究结果，在大脑和上半身的灌注方面，与其他模型相比，手术模型在大多数心率条件下具有最高的流量。它还在上腔血管中显示出与更好的动脉功能相关的振荡参数。在两种血管内手术中，与烟囱模型相比，杂交模型表现出稍好的血流动力学特征，在上腔血管中具有较低的剪切应力和更多的振荡流和 WSS。在休息状态（90BPM）下，杂交模型对上腔血管的灌注流量较低。然而，与其他模型不同的是，杂交模型的灌注随着心率的增加而增加，因此在 135BPM 时，它对上腔血管的流量与烟囱模型相似。本研究的结果可能为未来的腔内移植物设计和放置技术提供启示。
