Hemodynamic Analysis of Redissection after Endovascular Repair for One Stanford Type B Aortic Dissection Case
10.16156/j.1004-7220.2022.02.21
- VernacularTitle:1例Stanford B型主动脉夹层TEVAR术后新发破口的血流动力学分析
- Author:
Lingyan LI
1
;
Da LI
1
;
Yubo FAN
2
;
Ding YUAN
3
;
Jiarong WANG
3
;
Yingci ZHANG
4
;
Tinghu ZHENG
1
Author Information
1. Department of Applied Mechanics, Sichuan University
2. School of Medical Science and Engineering, Beihang University
3. Department of Vascular Surgery, West China Hospital, Sichuan University
4. Sichuan Vocational College of Cultural Industries
- Publication Type:Journal Article
- Keywords:
Stanford type B aortic dissection;
thoracic endovascular aortic repair(TEVAR);
numerical simulation;
distal re-entry tear;
hemodynamic analysis
- From:
Journal of Medical Biomechanics
2022;37(2):E323-E328
- CountryChina
- Language:Chinese
-
Abstract:
Objective Based on hemodynamic analysis, to investigate the cause of distal re-entry tear in Stanford type B aortic dissection after thoracic endovascular aortic repair (TEVAR).Methods A patient with type B aortic dissection was reexamined regularly with computed tomography angiography (CTA) at 1st month, 6th month, 12th month and 24th month after TEVAR. Based on the CTA images in each period, three-dimensional (3D) aorta models were reconstructed to perform morphological analysis and hemodynamic simulation.Results Compared with the diameter at 1st month after TEVAR, the diameter of true lumen at 12 months after TEVAR increased by 1.8 times and the global distortion of aorta increased by 16.67%. At postoperative 1st, 6th and 12th month, the maximum blood velocities at the new entry tear in systole were 69.6%, 33.7% and 92.1% higher than the average ones at distal landing zone, and the maximum wall shear stresses (WSSs) were 2.52, 2.32 and 3.52 times of the average WSSs respectively. In addition, the maximum time-averaged WSS (TAWSS) at 1st, 6th and 12th month after TEVAR were 1.88, 2.53 and 3.62 times of the mean TAWSS respectively.ConclusionsThe morphology of the aorta remodeled after TEVAR, and a sudden change in the diameter of true lumen occurred at distal anchoring zone and continued to increase. As a result, the blood flow velocity in this area accelerated, and the intima was continuously exposed to high WSS, leading to the redissection.
