The Department of Vascular and Transplant Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
The Department of Vascular and Transplant Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Ann Vasc Surg. 2022 Mar;80:256-263. doi: 10.1016/j.avsg.2021.08.044. Epub 2021 Nov 6.
Many new tools for abdominal aortic aneurysm (AAA) rupture risk evaluation have been developed. These new tools need detailed hemodynamic information in AAA. However, hemodynamic data obtained from in vivo research are lacking. Thus, the objective of this study was to analyze blood flow patterns in an in vivo AAA model to acquire real-time hemodynamic information using AneurysmFlow, a novel flow evaluation system.
Digital subtraction angiography images of patients who underwent endovascular aneurysm repair were analyzed using the visualization function of the AneurysmFlow to classify blood flow patterns as laminar or turbulent flow. The presence of boundary layer separation was also evaluated. The time taken for contrast medium to travel from the infrarenal aortic neck to aortic bifurcation was acquired to calculate the flow velocity. Associations between characteristics of aneurysm including lumen occupying ratio of intraluminal thrombus (ILT) and the hemodynamic flow pattern were evaluated.
A total of 37 AAA patients was enrolled. Their blood flow patterns were evaluated using the AneurysmFlow. Logistic regression analyses with lumen occupying ratio of ILT as an independent variable showed that the larger the lumen occupying ratio of ILT, the more likely the aneurysm was to show a laminar pattern (P = 0.03), and the more likely the boundary layer separation would not exist (P = 0.04). The flow velocity from the infrarenal aortic neck to the aortic bifurcation showed a positive association with the lumen occupying ratio of the ILT in linear regression analysis (P < 0.001).
Hemodynamic analysis of AAA with the AneurysmFlow using real-time individual patient models showed different flow patterns and flow velocities depending on ILT. This novel analytic approach using AneurysmFlow has potential to play an important role in obtaining clinically meaningful hemodynamic information of AAA.
许多新的工具已被开发出来，用于评估腹主动脉瘤（AAA）破裂的风险。这些新工具需要 AAA 中的详细血流动力学信息。然而，体内研究获得的血流动力学数据却很缺乏。因此，本研究的目的是使用一种新的血流评估系统——AneurysmFlow 来分析体内 AAA 模型中的血流模式，以获取实时血流动力学信息。
利用 AneurysmFlow 的可视化功能，对接受血管内动脉瘤修复术的患者的数字减影血管造影图像进行分析，将血流模式分类为层流或湍流。还评估了边界层分离的存在情况。获取对比剂从肾下主动脉颈到主动脉分叉处的传输时间，以计算流速。评估了包括腔内血栓（ILT）占据比在内的动脉瘤特征与血流动力学流动模式之间的关系。
共纳入 37 例 AAA 患者。使用 AneurysmFlow 评估了他们的血流模式。以 ILT 占据比为自变量的逻辑回归分析显示，ILT 占据比越大，动脉瘤越有可能呈现出层流模式（P=0.03），边界层分离越不可能存在（P=0.04）。从肾下主动脉颈到主动脉分叉处的流速与 ILT 的占据比呈线性回归分析的正相关（P<0.001）。
使用 AneurysmFlow 对个体患者模型进行实时 AAA 血流动力学分析，结果显示不同的血流模式和流速取决于 ILT。使用 AneurysmFlow 的这种新分析方法具有提供 AAA 有临床意义的血流动力学信息的潜力。
