支架和球囊形状对多重狭窄锥形血管内血流动力学的影响
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江苏省自然科学基金项目(BK20130525),江苏省高校自然科学基金项目(13KJB460006),中国博士后基金项目(2011M500858)


Effects of Stent and Balloon Shape on Hemodynamics in Tapered Vessels with Multiple Stenosis
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    摘要:

    目的 研究在多重狭窄的锥形血管中支架和球囊形状对血流动力学的影响。方法 建立血管支架植入多重狭窄锥形血管后的血流动力学模型,采用数值模拟方法研究不同形状支架和不同形状球囊搭配使用对术后血流动力学的影响。结果 分别使用圆柱形球囊和锥形球囊对圆柱形支架进行扩张,与圆柱形球囊扩张相比,锥形球囊扩张产生的低速血流区域的占比减小0.58%,低平均时间壁面剪应力区域的占比减小3.22%;使用锥形球囊分别对圆柱形支架和锥形支架进行扩张,与扩张锥形支架相比,扩张圆柱形支架产生的低速血流区域占比减小1.35%,低平均时间壁面剪应力区域占比减小9.73%。结论 多重狭窄锥形血管的血流动力学环境受到植入支架形状和球囊形状的影响;在多重狭窄的锥形血管中,采用锥形球囊扩张圆柱形支架可获得较好的血流动力学环境,降低支架内再狭窄发生的风险。研究结果为临床上介入方案的合理制定提供科学依据。

    Abstract:

    Objective To study the influence of stent and balloon shape on hemodynamics in tapered vessels with multiple stenosis. Methods The hemodynamic model was established after the implantation of vascular stent in tapered vessel with multiple stenosis. The numerical simulation method was used to study the effect of the combination of different shaped stents and balloons on postoperative hemodynamics. Results When the cylindrical stent was expanded using cylindrical balloon and tapered balloon respectively, compared with cylindrical balloon expansion, the proportion of low-speed blood flow area generated by tapered balloon expansion was reduced by 0.58%, and the proportion of low time-averaged wall shear stress (TAWSS) area was reduced by 3.22%. The use of tapered balloon for expansion could produce less low-speed blood flow and low TAWSS area. When tapered balloon was used to expand the cylindrical stent and tapered stent respectively, compared with expanding tapered stent, the proportion of low-speed blood flow area generated by expanding cylindrical stent decreased by 1.35%, and the proportion of low TAWSS area decreased by 9.73%. Conclusions The hemodynamic environment of tapered vessel with multiple stenosis was influenced by the shape of stent and balloon. The use of tapered balloon to expand the cylindrical stent in tapered vessels with multiple stenosis can achieve favorable hemodynamic environment and reduce the risk of ISR occurence. This study can provide a scientific basis for the rational formulation of clinical intervention scheme.

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申祥,刘强,许越,何泽文,陈嘉豪,蒋佳宝,晏恒峰.支架和球囊形状对多重狭窄锥形血管内血流动力学的影响[J].医用生物力学,2025,40(1):58-64

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  • 收稿日期:2024-08-08
  • 最后修改日期:2024-10-21
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  • 在线发布日期: 2025-02-26
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