Sengupta Sampad, Zhu Yu, Hamady Mohamad, Xu Xiao Yun
Department of Chemical Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
Department of Surgery & Cancer, Imperial College London, St. Mary's Campus, London W2 1NY, UK.
Bioengineering (Basel). 2022 Oct 18;9(10):573. doi: 10.3390/bioengineering9100573.
Thoracic endovascular aortic repair (TEVAR) of aortic aneurysms and dissections involving the arch has evolved over the last two decades. Compared to conventional surgical methods, endovascular repair offers a less invasive treatment option with lower risk and faster recovery. Endografts used in TEVAR vary in design depending on the procedure and application. Novel endografts (e.g., branched stent-graft) were developed to ensure perfusion of blood to the supra-aortic vessels, but their haemodynamic performance and long-term durability have not been adequately studied. This review focuses on the use of computational modelling to study haemodynamics in commercially available endografts designed for complex aortic arch repair. First, we summarise the currently adopted workflow for computational fluid dynamics (CFD) modelling, including geometry reconstruction, boundary conditions, flow models, and haemodynamic metrics of interest. This is followed by a review of recently (2010-present) published CFD studies on complex aortic arch repair, using both idealized and patient-specific models. Finally, we introduce some of the promising techniques that can be potentially applied to predict post-operative outcomes.
在过去二十年中，用于治疗累及主动脉弓的主动脉瘤和主动脉夹层的胸主动脉腔内修复术（TEVAR）不断发展。与传统手术方法相比，腔内修复术提供了一种侵入性较小的治疗选择，风险更低且恢复更快。TEVAR中使用的腔内移植物根据手术过程和应用的不同而设计各异。新型腔内移植物（例如分支型覆膜支架）已被开发出来以确保血液向主动脉弓上血管的灌注，但其血流动力学性能和长期耐用性尚未得到充分研究。本综述聚焦于使用计算模型来研究为复杂主动脉弓修复设计的市售腔内移植物中的血流动力学。首先，我们总结了当前采用的计算流体动力学（CFD）建模工作流程，包括几何重建、边界条件、流动模型以及感兴趣的血流动力学指标。接下来是对最近（2010年至今）发表的关于复杂主动脉弓修复的CFD研究的综述，这些研究使用了理想化模型和患者特异性模型。最后，我们介绍一些有望用于预测术后结果的技术。
