Fluid-structure interaction simulation of multiple overlapping uncovered stents intervention in aortic dissection
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    Abstract:

    Objective A one-way fluid-structure interaction (FSI) method based on an idealized aortic dissection model is proposed to analyze the hemodynamics and wall stress in the false lumen (FL) under the influence of multiple overlapping uncovered stents (MOUS). Methods Upon the establishment of the numerical model of one-way FSI of aortic dissection under the action of MOUS, the models were divided into two categories according to whether the model involved FL perfused branch artery. In the FSI model, the effect of blood flow on wall stress was considered, along with the hemodynamic analysis. The characteristics of hemodynamics and wall stress state in the post-operative scenarios were simulated under different surgical strategies. The wall stress state of the FL before and after thrombosis formation was also compared and analyzed. Results The release process of the stents has little influence on the simulation of the wall stress of the FL. The high velocity and high wall shear stress area in the FL cannot be reduced by using the MOUS alone. If only the proximal entry tear is blocked with a covered stent-graft, the distal end will maintain a region of high flow rate and high wall shear stress. Combination of covered stent-graft and MOUS will result in a region of low flow rate and low shear stress, as well as reduced wall pressure and wall stress in the FL Compared with the model with the FL perfused branch arteries, the model without it is more likely to form a region of low flow rate and low wall shear stress after surgery. However, the blood pressure in the FL was relatively higher. The formation of thrombus in the FL can greatly reduce the wall stress in the area covered by the thrombus. Conclusion The method proposed in this paper can simultaneously investigate the hemodynamics and wall stress characteristics of the FL, and provide support to study the mechanical mechanism behind the FL thrombolysis induced by MOUS and the post-operative aortic expansion.

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History
  • Received:December 05,2020
  • Revised:February 01,2021
  • Adopted:February 03,2021
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