1School of Mechanical Engineering, Jiangsu University of Technology, China.
2Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, China.
Acta Bioeng Biomech. 2024 Apr 15;26(1):23-35. doi: 10.37190/abb-02397-2024-04. Print 2024 Jun 1.
: Iliac vein stenting is the primary treatment for patients with iliac vein compression syndrome (IVCS). However, post-stent placement, patients often experience in-stent restenosis and thrombosis. Despite this, the role of lower limb movements in the functioning of stents and veins in IVCS patients remains unclear. This study aimed to address this knowledge gap by developing a computational model using medical imaging techniques to simulate IVCS after stent placement. : This research used a patient-specific model to analyze the effects of lower extremity exercises on hemodynamics post-stent placement. We conducted a comprehensive analysis to evaluate the impact of specific lower limb movements, including hip flexion, ankle movement and pneumatic compression on the hemo-dynamic characteristics within the treated vein. The analysis assessed parameters such as wall shear stress (WSS), oscillatory shear index (OSI), and residence time (RRT). : The results demonstrated that hip flexion significantly disrupts blood flow dynamics at the iliac vein bifurcation after stenting. Bilateral and left hip flexion were associated with pronounced regions of low WSS and high OSI at the iliac-vena junction and the stent segment. Additionally, active ankle exercise (AAE) and intermittent pump compression (IPC) therapy were found to enhance the occurrence of low WSS regions along the venous wall, potentially reducing the risk of thrombosis post-stent placement. Consequently, both active joint movements (hip and ankle) and passive movements have the potential to influence the local blood flow environment within the iliac vein after stenting. : The exploration of the impact of lower limb movements on hemodynamics provides valuable insights for mitigating adverse effects associated with lower limb movements post iliac-stenting. Bilateral and left hip flexions negatively impacted blood flow, increasing thrombosis risk. However, active ankle exercise and intermittent pump compression therapies effectively improve the patency.
髂静脉支架置入术是髂静脉压迫综合征（IVCS）患者的主要治疗方法。然而，支架置入后，患者常出现支架内再狭窄和血栓形成。尽管如此，下肢运动在 IVCS 患者支架和静脉功能中的作用仍不清楚。本研究旨在通过使用医学成像技术开发计算模型来模拟支架置入后的 IVCS，从而填补这一知识空白。
本研究使用患者特定模型来分析下肢运动对支架置入后血液动力学的影响。我们进行了全面分析，以评估特定下肢运动（包括髋关节屈曲、踝关节运动和气动压缩）对治疗静脉内血液动力学特征的影响。分析评估了壁面切应力（WSS）、振荡剪切指数（OSI）和停留时间（RRT）等参数。
结果表明，支架置入后髋关节屈曲会显著破坏髂静脉分叉处的血流动力学。双侧和左侧髋关节屈曲会导致髂-静脉交界处和支架段出现明显的低 WSS 和高 OSI 区域。此外，主动踝关节运动（AAE）和间歇性泵压（IPC）治疗被发现会增加静脉壁上低 WSS 区域的发生，从而降低支架置入后血栓形成的风险。因此，主动关节运动（髋关节和踝关节）和被动运动都有可能影响支架置入后髂静脉内的局部血流环境。
对下肢运动对血液动力学影响的探索为减轻髂支架置入后下肢运动相关不良影响提供了有价值的见解。双侧和左侧髋关节屈曲会降低血流，增加血栓形成的风险。然而，主动踝关节运动和间歇性泵压治疗可有效改善通畅性。
