双侧锁骨下动脉致病性低壁切应力的不对称分布：两例报告。
Asymmetric distribution of pathogenic low wall shear stress of the bilateral subclavian arteries: two case reports.
机构信息
Department of Neurology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
College of Aeronautics and Astronautics, 12377Zhejiang University, Zhejiang University, Hangzhou, Zhejiang Province, China.
出版信息
J Int Med Res. 2021 Sep;49(9):3000605211042503. doi: 10.1177/03000605211042503.
The effects of increasing blood flow on the pathogenic wall shear stress (pWSS) of subclavian arteries (SAs) are currently unclear. Patient-specific models of the SA were constructed based on computed tomographic images from two patients. Using the Ansys Fluent 19.0 transient laminar flow solver, the finite volume method was chosen to solve the Navier-Stokes equation governing fluid behavior. The time-averaged wall shear stress, ratio of risk area, cumulative ratio of risk area (), ratio of risk time, and ratio contour of risk time were calculated to describe the temporal and spatial distributions of pWSS. Virtually all pWSS occurred during the diastolic phase. The was 2.3 and 1.29 times higher on the left than on the right in Patients 1 (P1) and 2 (P2), respectively. Increasing the blood flow volume of the left SA by 20%, 40%, and 60% led to a 9.27%, 15.10%, and 20.99% decrease in for P1 and a 5.74%, 11.55%, and 17.14% decrease in for P2, respectively, compared with baseline values. In conclusion, the left SA showed greater diastolic pWSS than the right SA, and increasing the blood flow volume reduced the pWSS in the left SA.
目前尚不清楚增加血流量对锁骨下动脉（SA）致病壁切应力（pWSS）的影响。根据来自两名患者的计算机断层扫描图像，构建了特定于患者的 SA 模型。使用 Ansys Fluent 19.0 瞬态层流求解器，选择有限体积法来求解控制流体行为的纳维-斯托克斯方程。计算了时均壁切应力、危险区域比、危险区域累积比（）、危险时间比和危险时间比轮廓比，以描述 pWSS 的时空分布。几乎所有的 pWSS 都发生在舒张期。在患者 1（P1）和患者 2（P2）中，左侧的壁切应力分别比右侧高 2.3 倍和 1.29 倍。与基线值相比，当左 SA 的血流量增加 20%、40%和 60%时，P1 的分别减少了 9.27%、15.10%和 20.99%，P2 的分别减少了 5.74%、11.55%和 17.14%。总之，左 SA 的舒张期 pWSS 大于右 SA，增加血流量会降低左 SA 的 pWSS。
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