Wang Yuzhu, Sang Yuna, Li Wendong, Zhou Minjie, Zhao Yushun, He Xiaodong, Wang Chao, Li Xiaoqiang, Liu Zhao
Department of Vascular Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China.
School of Astronautics, Harbin Institute of Technology, Harbin 150080, China.
Bioengineering (Basel). 2025 May 1;12(5):482. doi: 10.3390/bioengineering12050482.
(1) Background: Renal artery occlusion after F/B EVAR for abdominal aortic aneurysm is a serious complication that may require re-intervention, and understanding the hemodynamic mechanisms by which it occurs is essential to optimize the surgical procedure. (2) Methods: We used computational fluid dynamics (CFD) to analyze the impact of various parameters on blood flow. Theoretical vascular models were constructed based on the common dimensions and angles of aortic stents and branch arteries in clinical practice. Actual case models were constructed from CT image data of six patients treated with F/B-EVAR. Data were collected for analysis after simulation and calculation by FLUENT software. (3) Results: Theoretical model simulations showed that a larger tilt angle of the branch stent, smaller branch entry depth, and larger branch stent diameter were beneficial for blood flow. In the case models, a significant difference in the tilt angle of the renal artery stents was observed between the high- and low-flow groups, while the differences in entry depth and branch stent diameter were not significant. Occluded renal arteries had lower WSS values than patent ones. (4) Conclusions: This study offers valuable guidance for optimizing stent placement in F/B EVAR to mitigate renal artery occlusion risk.
(1) 背景：腹主动脉瘤行开窗/分支型腔内修复术（F/B EVAR）后肾动脉闭塞是一种严重并发症，可能需要再次干预，了解其发生的血流动力学机制对于优化手术操作至关重要。(2) 方法：我们使用计算流体动力学（CFD）分析各种参数对血流的影响。基于临床实践中主动脉支架和分支动脉的常见尺寸和角度构建理论血管模型。从6例行F/B-EVAR治疗的患者的CT图像数据构建实际病例模型。通过FLUENT软件进行模拟和计算后收集数据进行分析。(3) 结果：理论模型模拟显示，分支支架倾斜角度较大、分支入口深度较小和分支支架直径较大有利于血流。在病例模型中，高流量组和低流量组肾动脉支架倾斜角度存在显著差异，而入口深度和分支支架直径差异不显著。闭塞的肾动脉壁面切应力（WSS）值低于通畅的肾动脉。(4) 结论：本研究为优化F/B EVAR中支架置入以降低肾动脉闭塞风险提供了有价值的指导。
