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Chapter 7 CFD Reconstruction of Blood Hemodynamic Based on a Self-made Algorithm in Patients with Acute Type IIIb Aortic Dissection Treated with TEVAR Procedure

机译:第7章基于TEVAR手术治疗急性型IIIB主动脉夹层患者自制算法血液动力学的CFD重建

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Background: Combination of computational fluid dynamic (CFD) technique and medical data (AngioCT and USG-Doppler data) allowed preparation of a non-invasive method for blood hemodynamic analysis in type B aortic dissection (TBAD). Materials and methods: Three-dimensional digital models of the aorta were reconstructed using pre- and post-operative data from a 39-year-old patient treated for acute TBAD with thoracic endovascular aortic repair (TEVAR). Moreover, the left renal artery and the right common iliac artery were treated with additional stents. CFD technique was used to quantify the displacement forces acting on the aortic wall in the areas of endograft and validated with USG-Doppler data. The aortic segment was extended from the origin of the aortic arch to the aortic bifurcation. Results: Our results indicated that prostheses implantation improved overall aortic blood flow. We observed that blood flow rate was around two-fold higher in branching arteries of the aorta after surgical procedure. The wall shear stress (WSS) values were lower in all analysed areas. Hence, the overall risk of dissection propagation and rupture was decreased. Conclusion: CFD technique may provide qualitative assessment of hemodynamic forces in the aorta before and after prostheses implantation and may have potential in aiding the therapeutic decision-making process after operation.
机译:背景:计算流体动力学(CFD)技术和医疗数据(血管电压和USG-DoPpler数据)的组合允许制备B型主动脉夹层(TBAD)中的血液血流动力学分析的非侵入性方法。材料和方法:使用来自胸腔内血管主动脉修复(TEVAR)的急性TBAD治疗的39岁患者的39岁患者的术前数据重建主动脉的三维数字模型。此外,用另外的支架处理左肾动脉和正确的髂髂动脉。 CFD技术用于量化在内切拉移植区域的主动脉壁上作用的位移力,并用USG-DoPpler数据验证。主动脉段从主动脉弓的来源延伸到主动脉分叉。结果:我们的结果表明假体植入改善了整体主动脉血流。我们观察到,手术手术后主动脉的分支动脉血流流速高约两倍。在所有分析的区域中,壁剪切应力(WSS)值较低。因此,减少了解剖繁殖和破裂的总体风险。结论:CFD技术可以在假体植入前后主动脉血流动力的定性评估,并且可能具有在运作后实现治疗决策过程的潜力。

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