[1]滕碧云,王 哲,周治军,等.基于曲率的破裂腹主动脉瘤计算流体力学研究[J].介入放射学杂志,2022,31(07):664-668.
 TENG Biyun,WANG Zhe,ZHOU Zhijun,et al.Curvature-based computational fluid dynamics of ruptured abdominal aortic aneurysms[J].journal interventional radiology,2022,31(07):664-668.
点击复制

基于曲率的破裂腹主动脉瘤计算流体力学研究()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年07
页码:
664-668
栏目:
血管介入
出版日期:
2022-09-03

文章信息/Info

Title:
Curvature-based computational fluid dynamics of ruptured abdominal aortic aneurysms
作者:
滕碧云 王 哲 周治军 赵 渝
Author(s):
TENG Biyun WANG Zhe ZHOU Zhijun ZHAO Yu.
Department of Vascular Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
关键词:
【关键词】 腹主动脉瘤 曲率 计算流体力学 血流动力学
文献标志码:
A
摘要:
【摘要】 目的 分析破裂和未破裂腹主动脉瘤(AAA)曲率和血流动力学参数差异,探讨AAA破裂相关风险。 方法 回顾性分析2019年10月至2020年12月在重庆医科大学附属第一医院确诊并接受治疗的35例AAA患者临床资料,其中瘤体破裂13例,未破裂22例。依据患者CTA影像资料,采用计算流体力学(CFD)方法分析比较两组患者解剖学因素和血流动力学参数间差异和相关性。结果 破裂组AAA破裂处壁剪切应力(WSS)显著小于最大血流冲击处WSS[0.025(0.049/0.018) Pa比0.549(0.839/0.492) Pa,P=0.01]。未破裂组瘤体最大血流冲击处WSS显著大于破裂组[(1.378±0.255) Pa比0.549(0.839/0.492) Pa,P<0.01]。破裂组与未破裂组瘤体最大直径[(79.847±10.067) mm比(52.320±14.682) mm,P<0.01]、曲率[(0.139±0.050)比0.080(0.123/0.068),P=0.021]差异均有统计学意义。瘤体最大直径与瘤颈直径呈负相关(r=-0.732,P<0.01),与曲率呈正相关(r=0.492,P=0.003)。 结论 解剖因素曲率和血流动力学参数WSS可影响AAA破裂,对AAA破裂有一定的预测作用。

参考文献/References:

[1] 王 磊,潘柏宏,杨 璞,等. 美国血管外科学会2018年腹主动脉瘤诊治指南解读[J]. 中国普通外科杂志, 2018, 27:1505- 1510.
[2] Lozowy RJ, Kuhn DC, Ducas AA, et al. The relationship between pulsatile flow impingement and intraluminal thrombus deposition in abdominal aortic aneurysms[J]. Cardiovasc Eng Technol, 2017, 8: 57- 69.
[3] Rissland P, Alemu Y, Einav S, et al. Abdominal aortic aneurysm risk of rupture: patient- specific FSI simulations using anisotropic model[J]. J Biomech Eng, 2009, 131: 031001.
[4] Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm[J]. J Vasc Surg, 2018, 67:2.e2- 77.e2.
[5] 张学敬,郝伟丽,杨松涛,等. 分支血管异常增大的血流动力学应力促进前交通动脉瘤形成[J]. 介入放射学杂志, 2019, 28:625- 629.
[6] Boyd AJ, Kuhn DC, Lozowy RJ, et al. Low wall shear stress predominates at sites of abdominal aortic aneurysm rupture[J]. J Vasc Surg, 2016, 63: 1613- 1619.
[7] Raghavan ML, Vorp DA. Toward a biomechanical tool to evaluate rupture potential of abdominal aortic aneurysm: identification of a finite strain constitutive model and evaluation of its applicability[J]. J Biomech, 2000, 33: 475- 482.
[8] Xing R, Moerman AM, Ridwan RY, et al. The effect of the heart rate lowering drug ivabradine on hemodynamics in atherosclerotic mice[J]. Sci Rep, 2018, 8: 14014.
[9] Georgakarakos E, Ioannou CV, Papaharilaou Y, et al. Computa-tional evaluation of aortic aneurysm rupture risk: what have we learned so far?[J]. J Endovasc Ther, 2011, 18:214- 225.
[10] Jing L, Fan J, Wang Y, et al. Morphologic and hemodynamic analysis in the patients with multiple intracranial aneurysms: ruptured versus unruptured[J]. PloS one, 2015, 10:e0132494.
[11] Nieto- Palomo F, Perez- Rueda MA, Lipsa LM, et al. Statistical techniques for predicting rupture risk in abdominal aortic aneurysms: a contribution based on bootstrap[J]. Sci Prog, 2021, 104: 368504211003785.
[12] 孙敏敏. AAA瘤体大小与不良近端瘤颈形态的相关性分析及其在EVAR治疗中的应用[D]. 福建:福建医科大学, 2018.
[13] Stark M, Suresh A, Alexander J, et al. An analysis of variables affecting aortic neck length with implications for fenestrated endovascular repair of abdominal aortic aneurysm[J]. Ann Vasc Surg, 2014, 28: 808- 815.
[14] Lee KM, Choi SY, Kim MU, et al. Effects of anatomical charac- teristics as factors in abdominal aortic aneurysm rupture: CT aortography analysis[J]. Medicine(Baltimore), 2017, 96: e7236.
[15] Armon MP, Yusuf SW, Whitaker SC, et al. Influence of abdominal aortic aneurysm size on the feasibility of endovascular repair[J]. J Endovasc Surg, 1997, 4: 279- 283.
[16] Murayama Y, Fujimura S, Suzuki T, et al. Computational fluid dynamics as a risk assessment tool for aneurysm rupture[J]. Neurosurg Focus, 2019, 47: E12.
[17] Meng H, Tutino VM, Xiang J, et al. High WSS or low WSS? Complex interactions of hemodynamics with intracranial aneurysm initiation, growth, and rupture: toward a unifying hypothesis[J]. AJNR Am J Neuroradiol, 2014, 35:1254- 1262.
[18] Lu G, Huang L, Zhang XL, et al. Influence of hemodynamic factors on rupture of intracranial aneurysms: patient- specific 3D mirror aneurysms model computational fluid dynamics simulation[J]. AJNR Am J Neuroradiol, 2011, 32: 1255- 1261.
[19] 舒 畅,王 暾. 腹主动脉瘤血流动力学特点和对策[J]. 中国实用外科杂志, 2012, 32:983- 985.
[20] Zambrano BA, Gharahi H, Lim C, et al. Association of intraluminal thrombus, hemodynamic forces, and abdominal aortic aneurysm expansion using longitudinal CT images[J]. Ann Biomed Eng, 2016, 44: 1502- 1514.
[21] 周治军,王 哲,赵珅宇,等. 基于计算流体力学的腹主动脉瘤破裂风险研究[J]. 介入放射学杂志, 2020, 29:763- 767.
[22] Raut SS, Chandra S, Shum J, et al. The role of geometric and biomechanical factors in abdominal aortic aneurysm rupture risk assessment[J]. Ann Biomed Eng, 2013, 41: 1459- 1477.
[23] Polzer S, Gasser TC, Swedenborg J, et al. The impact of intralu-minal thrombus failure on the mechanical stress in the wall of abdominal aortic aneurysms[J]. Eur J Vasc Endovasc Surg, 2011, 41: 467- 473.
[24] Haller SJ, Crawford JD, Courchaine KM, et al. Intraluminal thrombus is associated with early rupture of abdominal aortic aneurysm[J]. J Vasc Surg, 2018, 67: 1051.e1- 1058.e1.
[25] Lasheras JC. The biomechanics of arterial aneurysms[J]. Annu Rev Fluid Mech, 2007, 39: 293- 319.

相似文献/References:

[1]谷涌泉,刘一人,郭连瑞,等.主动脉腔内修复术中髂内动脉保留技术[J].介入放射学杂志,2017,(02):184.
 GU Yongquan,LIU Yiren,GUO Lianrui,et al.Preservation technique of internal iliac artery in performing endovascular aortic repair [J].journal interventional radiology,2017,(07):184.
[2]佟 铸,谷涌泉,郭连瑞,等.局部麻醉穿刺下完全无对比剂腔内修复腹主动脉瘤1例 [J].介入放射学杂志,2017,(07):594.
 TONG Zhu,GU Yongquan,GUO Lianrui,et al.Percutaneous endovascular aorta repair under local anesthesia with no use of any contrast agent for abdominal aortic aneurysm: initial experience in one patient [J].journal interventional radiology,2017,(07):594.
[3]刘军军,冯 睿,周 建,等.可控释支架移植物台上开窗治疗近肾腹主动脉瘤[J].介入放射学杂志,2018,27(05):404.
 LIU Junjun,FENG Rui,ZHOU Jian,et al.On- table fenestrated EVAR technique by using release- controllable stent system for the treatment of abdominal aortic aneurysm located near the kidney[J].journal interventional radiology,2018,27(07):404.
[4]张茅平,骆曦图,黄宝骏,等.腹主动脉瘤主动脉腔内修复术后消耗性凝血功能障碍的诊断和治疗[J].介入放射学杂志,2019,28(09):900.
 ZHANG Maoping,LUO Xitu,HUANG Baojun,et al.The diagnosis and treatment of consumptive coagulopathy following endovascular repair of abdominal aortic aneurysm[J].journal interventional radiology,2019,28(07):900.
[5]周治军,王 哲,赵珅宇,等.基于计算流体力学的腹主动脉瘤破裂风险研究 [J].介入放射学杂志,2020,29(08):763.
 ZHOU Zhijun,WANG Zhe,ZHAO Shenyu,et al.Study on the rupture risks of abdominal aortic aneurysm based on computational fluid dynamics[J].journal interventional radiology,2020,29(07):763.
[6]王弼偲,朱 智,张鑫鹏.内分支联合体外预开窗技术在腹主动脉瘤内脏分支重建中的应用[J].介入放射学杂志,2021,30(10):1044.
 WANG Bisi,ZHU Zhi,ZHANG Xinpeng,et al.Application of internal branch combined with external pre-fenestration technology in reconstructing visceral branches in patients with abdominal aortic aneurysm[J].journal interventional radiology,2021,30(07):1044.
[7]厉祥涛,张 欢,张明逸,等.磁性导丝辅助腹主动脉瘤腔内修复术中通路建立的初步研究[J].介入放射学杂志,2021,30(11):1109.
 LI Xiangtao,ZHANG Huan,ZHANG Mingyi,et al.Application of magnetic guidewire-assisted vascular access establishment in endovascular repair of abdominal aneurysm: preliminary results in experimental sheep[J].journal interventional radiology,2021,30(07):1109.
[8]安 涛,阮 娜,李文怡,等.CTA融合导航技术在腹主动脉瘤腔内修复及保留髂内动脉治疗中的应用[J].介入放射学杂志,2022,31(11):1093.
 AN Tao,RUAN Na,LI Wenyi,et al.Application of CTA fusion navigation technique in endovascular repair of abdominal aortic aneurysm with simultaneously preserving internal iliac artery[J].journal interventional radiology,2022,31(07):1093.
[9]翟思敏,李海燕,陆清声.腹主动脉瘤合并主动脉肠瘘患者的围手术期护理1例[J].介入放射学杂志,2023,32(08):807.
 ZHAI Simin,LI Haiyan,LU Qingsheng..Perioperative nursing for patients with abdominal aortic aneurysm complicated by aortoenteric fistula: report of one case[J].journal interventional radiology,2023,32(07):807.

备注/Memo

备注/Memo:
(收稿日期:2021- 05- 23)
(本文编辑:边 佶)
更新日期/Last Update: 2022-09-02