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首页> 外文期刊>Journal of Biomechanics >Numerical investigations of the haemodynamic changes associated with stent malapposition in an idealised coronary artery
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Numerical investigations of the haemodynamic changes associated with stent malapposition in an idealised coronary artery

机译：理想化冠状动脉中与支架贴壁不良相关的血流动力学变化的数值研究

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The deployment of a coronary stent near complex lesions can sometimes lead to incomplete stent apposition (ISA), an undesirable side effect of coronary stent implantation. Three-dimensional computational fluid dynamics (CFD) calculations are performed on simplified stent models (with either square or circular cross-section struts) inside an idealised coronary artery to analyse the effect of different levels of ISA to the change in haemodynamics inside the artery. The clinical significance of ISA is reported using haemodynamic metrics like wall shear stress (WSS) and wall shear stress gradient (WSSG). A coronary stent with square cross-sectional strut shows different levels of reverse flow for malapposition distance (MD) between 0. mm and 0.12 mm. Chaotic blood flow is usually observed at late diastole and early systole for MD=0 mm and 0.12 mm but are suppressed for MD=0.06 mm. The struts with circular cross section delay the flow chaotic process as compared to square cross-sectional struts at the same MD and also reduce the level of fluctuations found in the flow field. However, further increase in MD can lead to chaotic flow not only at late diastole and early systole, but it also leads to chaotic flow at the end of systole. In all cases, WSS increases above the threshold value (0.5 Pa) as MD increases due to the diminishing reverse flow near the artery wall. Increasing MD also results in an elevated WSSG as flow becomes more chaotic, except for square struts at MD=0.06 mm.
机译：在复杂病变附近部署冠状动脉支架有时会导致不完全的支架并置（ISA），这是冠状动脉支架植入术的不良副作用。在理想化的冠状动脉内，对简化的支架模型（具有方形或圆形横截面支杆）进行三维计算流体动力学（CFD）计算，以分析不同水平的ISA对动脉内血流动力学变化的影响。 ISA的临床意义是通过使用血流动力学指标（如壁切应力（WSS）和壁切应力梯度（WSSG））来报告的。带有正方形横截面支杆的冠状动脉支架的错位距离（MD）在0. mm和0.12 mm之间显示出不同水平的反向流动。对于MD = 0 mm和0.12 mm，通常在舒张末期和收缩末期观察到混沌的血流，但对于MD = 0.06 mm，血流被抑制。与具有相同MD的方形截面支杆相比，具有圆形截面的支杆延迟了流动混沌过程，并且还减少了流场中的波动水平。但是，MD的进一步增加不仅会导致舒张末期和收缩早期的混乱，而且还会导致收缩末期的混乱。在所有情况下，由于动脉壁附近的反向流量减少，MD增大，WSS增大到阈值（0.5 Pa）以上。 MD的增加也会导致WSSG的升高，因为流动变得更加混乱，除了MD = 0.06 mm的方柱。

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