Jiang Xu-Dong, Ye Sheng-Lin, Zhang Ming, Li Xiao-Qiang, Sun Li-Li
Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.
Heliyon. 2023 Feb 11;9(2):e13681. doi: 10.1016/j.heliyon.2023.e13681. eCollection 2023 Feb.
The aim of this study was to perform hemodynamic simulations of a three-dimension ideal inferior vena cava-iliac vein model with artificial stenosis to determine the degree of stenosis that requires clinical intervention.
Four three-dimension stenosis models (30%, 50%, 70%, and 90% stenosis) were constructed using commercial software (Solidworks). The inlet flow rates were acquired from previous literatures to perform the hemodynamic simulations. Changes in the old blood volume fraction, as well conventional hemodynamic parameters including pressure, differential pressure, wall shear stress, and flow patterns, over time were recorded. The pressure at the telecentric region of the stenosis increased with increasing degree of stenosis.
For the 70% stenosis model, the pressure at the telecentric region of the stenosis reached 341 Pa, and the differential pressure between the two ends of the stenosis was 363 Pa (approximately 2.7 mmHg). Moreover, in the 70% and 90% stenosis models, there was a marked change in wall shear stress in the stenosis and the proximal end region, and the flow patterns began to show the phenomenon of flow separation. Blood stasis analysis showed that the 70% stenosis model had the slowest decrease in old blood volume fraction, while the proximal end region had the largest blood residue (15%).
Iliac vein stenosis of approximately 70% is associated with clinically relevant hemodynamic changes, and is more closely related to DVT than other degrees of stenosis.
本研究的目的是对具有人工狭窄的三维理想下腔静脉 - 髂静脉模型进行血流动力学模拟，以确定需要临床干预的狭窄程度。
使用商业软件（Solidworks）构建四个三维狭窄模型（30%、50%、70%和90%狭窄）。从先前的文献中获取入口流速以进行血流动力学模拟。记录陈旧血液体积分数的变化以及包括压力、压差、壁面剪应力和流型等传统血流动力学参数随时间的变化。狭窄远心端区域的压力随着狭窄程度的增加而升高。
对于70%狭窄模型，狭窄远心端区域的压力达到341 Pa，狭窄两端的压差为363 Pa（约2.7 mmHg）。此外，在70%和90%狭窄模型中，狭窄及近端区域的壁面剪应力有明显变化，流型开始出现流动分离现象。血液瘀滞分析表明，70%狭窄模型的陈旧血液体积分数下降最慢，而近端区域的血液残留量最大（15%）。
约70%的髂静脉狭窄与临床相关的血流动力学变化有关，并且与深静脉血栓形成的关系比其他狭窄程度更为密切。
