双开窗技术治疗复杂主动脉夹层的血流动力学分析
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内蒙古自治区自然科学基金项目(2020MS05035);内蒙古自治区直属高校基本科研业务费项目(JY20220285)


Hemodynamic Analysis of Double-Fenestration Technique for Treating Complex Aortic Dissection
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    摘要:

    目的 依据临床手术统计实例,探究双开窗分支支架不同深度植入病变胸主动脉后血流场的影响。方法 建立胸主动脉、胸主动脉覆膜支架以及分支血管覆膜支架,采用有限元计算方法,对分支支架不同深度(5、10、15 mm)植入病变主动脉进行分析,借助体外测速实验平台,进行实验验证。结果 分支支架不同深度植入胸主动脉对维持血流场稳定灌注存在一定规律,其中D10-5组(左颈总动脉分支支架、左锁骨下动脉分支支架植入深度分别为10、5 mm)的分支血管血流灌注率处于良好水平,TAWSSmax为最低水平的44.94 Pa,为仿真结果最优组。结论 保持左锁骨下动脉分支支架植入胸主动脉较短的情况下,适当增加左颈总动脉分支支架植入主动脉的深度,可以获得更为稳定的血流场。研究结果为临床双开窗技术实践提供理论参考。

    Abstract:

    Objective Based on clinical surgical statistical instances, the influence of double fenestration branch stents on the blood flow field after different depths of implantation in the diseased thoracic aorta was investigated. Methods Thoracic aorta, thoracic aorta-coated stent, and branch vessel-coated stent were established. The finite element calculation method was used to analyze the branch stent implanted into the diseased aorta at different depths (5, 10, and 15 mm), and experimental verification was performed using an in vitro tachymetry experimental platform. Results There were certain patterns for maintaining stable perfusion of the blood flow field with branch stent implantation at different depths in the thoracic aorta. The branch blood perfusion rate in Group D10-5 (the implantation depths of the left common carotid artery branch stent and left subclavian artery branch stent were 10 mm and 5 mm, respectively) was at a good level, and TAWSSmax was at the lowest level (44.94 Pa), thereby showing the best simulation results. Conclusions When the left subclavian artery branch stent implantation in the thoracic aorta was short, the depth of the left common carotid artery branch stent implantation in the aorta was appropriately increased to obtain a more stable blood flow field. This study provided a theoretical reference for the double-fenestration technique in clinical practice.

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王旭,韩青松,白李波,冯海全.双开窗技术治疗复杂主动脉夹层的血流动力学分析[J].医用生物力学,2024,39(5):860-865

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  • 收稿日期:2024-03-31
  • 最后修改日期:2024-05-11
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  • 在线发布日期: 2024-10-25
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