Approaches for Treatment of Aortic Arch Aneurysm, A Numerical Study

Publication date: Available online 12 November 2016
Source:Journal of Biomechanics
Author(s): Asaph Nardi, Idit Avrahami
Aortic arch aneurysm is a complex pathology which requires coverage of one or more aortic arch vessels. In this study we explore the hemodynamic behavior of the aortic arch in aneurysmatic and treated cases with three currently available treatment approaches: Surgery Graft, hybrid Stent-Graft and Chimney Stent Graft. The analysis included four models of the time-dependent fluid domains of aneurysmatic arch and of the Surgery, hybrid and chimney endovascular techniques. Dimensions of the models are based on typical anatomy, and boundary conditions are based on typical physiological flow.The simulations used computational fluid dynamics (CFD) methods to delineate the time-dependent flow dynamics in the four geometric models.Results of velocity vectors, flow patterns, blood pressure and wall shear stress distributions are presented.The results delineate disturbed and recirculating flow in the aortic arch aneurysm accompanied with low wall shear stress and velocities, compared to a uniformly directed flow and nominal wall shear stress (WSS) in the model of Surgery graft. Out of the two minimally-invasive procedures, the Hybrid procedure clearly exhibits better hemodynamic performances over the Chimney model, with lower WSS, lower pressure drop and less disturbed and vortical flow regions. Although the Chimney procedure requires less manufacturing time and cost, it is associated with higher risk rates, and therefore, it is recommended only for emergency cases. This study may shed light on the hemodynamic factors for these complications and provide insight into ways to improve the procedure.



from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2g2FU9N
via IFTTT