A Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck

Objectives: Cross-limb stent grafts for endovascular aneurysm repair (EVAR) are often employed for abdominal aortic aneurysms (AAAs) with significant aortic neck angulation. Neck angulation may be coronal or sagittal; however, previous hemodynamic studies of cross-limb EVAR stent grafts (SGs) primar...

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Autores principales:	Ming Qing, Yue Qiu, Jiarong Wang, Tinghui Zheng, Ding Yuan
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	abdominal aortic aneurysm endovascular aneurysm repair cross limb technology stent-graft hemodynamics Physiology QP1-981
Acceso en línea:	https://doaj.org/article/0f3a9600fbc24791aeea67cc0c184619
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spelling	oai:doaj.org-article:0f3a9600fbc24791aeea67cc0c1846192021-12-02T09:25:59ZA Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck1664-042X10.3389/fphys.2021.795085https://doaj.org/article/0f3a9600fbc24791aeea67cc0c1846192021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphys.2021.795085/fullhttps://doaj.org/toc/1664-042XObjectives: Cross-limb stent grafts for endovascular aneurysm repair (EVAR) are often employed for abdominal aortic aneurysms (AAAs) with significant aortic neck angulation. Neck angulation may be coronal or sagittal; however, previous hemodynamic studies of cross-limb EVAR stent grafts (SGs) primarily utilized simplified planar neck geometries. This study examined the differences in flow patterns and hemodynamic parameters between crossed and non-crossed limb SGs at different spatial neck angulations.Methods: Ideal models consisting of 13 cross and 13 non-cross limbs were established, with coronal and sagittal angles ranging from 0 to 90°. Computational fluid dynamics (CFD) was used to capture the hemodynamic information, and the differences were compared.Results: With regards to the pressure drop index, the maximum difference caused by the configuration and angular direction was 4.6 and 8.0%, respectively, but the difference resulting from the change in aneurysm neck angle can reach 27.1%. With regards to the SAR-TAWSS index, the maximum difference caused by the configuration and angular direction was 7.8 and 9.8%, respectively, but the difference resulting from the change in aneurysm neck angle can reach 26.7%. In addition, when the aneurysm neck angle is lower than 45°, the configuration and angular direction significantly influence the OSI and helical flow intensity index. However, when the aneurysm neck angle is greater than 45°, the hemodynamic differences of each model at the same aneurysm neck angle are reduced.Conclusion: The main factor affecting the hemodynamic index was the angle of the aneurysm neck, while the configuration and angular direction had little effect on the hemodynamics. Furthermore, when the aneurysm neck was greatly angulated, the cross-limb technique did not increase the risk of thrombosis.Ming QingMing QingYue QiuYue QiuJiarong WangTinghui ZhengTinghui ZhengDing YuanDing YuanFrontiers Media S.A.articleabdominal aortic aneurysmendovascular aneurysm repaircross limb technologystent-grafthemodynamicsPhysiologyQP1-981ENFrontiers in Physiology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	abdominal aortic aneurysm endovascular aneurysm repair cross limb technology stent-graft hemodynamics Physiology QP1-981
spellingShingle	abdominal aortic aneurysm endovascular aneurysm repair cross limb technology stent-graft hemodynamics Physiology QP1-981 Ming Qing Ming Qing Yue Qiu Yue Qiu Jiarong Wang Tinghui Zheng Tinghui Zheng Ding Yuan Ding Yuan A Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck
description	Objectives: Cross-limb stent grafts for endovascular aneurysm repair (EVAR) are often employed for abdominal aortic aneurysms (AAAs) with significant aortic neck angulation. Neck angulation may be coronal or sagittal; however, previous hemodynamic studies of cross-limb EVAR stent grafts (SGs) primarily utilized simplified planar neck geometries. This study examined the differences in flow patterns and hemodynamic parameters between crossed and non-crossed limb SGs at different spatial neck angulations.Methods: Ideal models consisting of 13 cross and 13 non-cross limbs were established, with coronal and sagittal angles ranging from 0 to 90°. Computational fluid dynamics (CFD) was used to capture the hemodynamic information, and the differences were compared.Results: With regards to the pressure drop index, the maximum difference caused by the configuration and angular direction was 4.6 and 8.0%, respectively, but the difference resulting from the change in aneurysm neck angle can reach 27.1%. With regards to the SAR-TAWSS index, the maximum difference caused by the configuration and angular direction was 7.8 and 9.8%, respectively, but the difference resulting from the change in aneurysm neck angle can reach 26.7%. In addition, when the aneurysm neck angle is lower than 45°, the configuration and angular direction significantly influence the OSI and helical flow intensity index. However, when the aneurysm neck angle is greater than 45°, the hemodynamic differences of each model at the same aneurysm neck angle are reduced.Conclusion: The main factor affecting the hemodynamic index was the angle of the aneurysm neck, while the configuration and angular direction had little effect on the hemodynamics. Furthermore, when the aneurysm neck was greatly angulated, the cross-limb technique did not increase the risk of thrombosis.
format	article
author	Ming Qing Ming Qing Yue Qiu Yue Qiu Jiarong Wang Tinghui Zheng Tinghui Zheng Ding Yuan Ding Yuan
author_facet	Ming Qing Ming Qing Yue Qiu Yue Qiu Jiarong Wang Tinghui Zheng Tinghui Zheng Ding Yuan Ding Yuan
author_sort	Ming Qing
title	A Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck
title_short	A Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck
title_full	A Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck
title_fullStr	A Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck
title_full_unstemmed	A Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck
title_sort	comparative study on the hemodynamic performance within cross and non-cross stent-grafts for abdominal aortic aneurysms with an angulated neck
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/0f3a9600fbc24791aeea67cc0c184619
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A Comparative Study on the Hemodynamic Performance Within Cross and Non-cross Stent-Grafts for Abdominal Aortic Aneurysms With an Angulated Neck

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