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Effect of Geometric Accuracy at the Proximal Landing Zone on Simulation Results for Thoracic Endovascular Repair Patients

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Abstract

Purpose

Existing hemodynamic studies on aortic dissection after thoracic endovascular aortic repair (TEVAR) apply geometric simplifications. This study aims to evaluate the necessity of more accurate geometries at the proximal landing zone in computational fluid dynamic (CFD) studies.

Methods

Three patient-specific 3D aortic dissection models with different geometric accuracies at the proximal landing zone were manually fabricated for CFD simulations: (i) model 1 without the stent graft (SG), (ii) model 2 with the metal stent, and (iii) model 3 with the SG. The flow distribution, flow pattern, and wall shear stress (WSS)-related indicators in these three models were compared.

Results

The flow distributions were quite similar for the three models, with a maximum absolute difference of 0.27% at the left suclavian artery (LSA) between models 1 and 3 because of partial coverage. A more chaotic flow pattern was observed at the proximal landing zone in model 3, with significant regional differences in the WSS-related indicator distributions. The upstream and downstream WSS-related indicator distributions were quite similar for the three models.

Conclusions

The flow pattern and hemodynamic parameter distributions were affected by the geometric accuracy only in a small region near the proximal landing zone. The flow split was hardly affected by the LSA partial coverage, indicating that the coverage may have slight effects on short-term blood perfusion. However, this conclusion needs to be verified in future studies with larger sample sizes.

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Abbreviations

TEVAR:

Thoracic Endovascular Aortic Repair

AD:

Aortic Dissection

CFD:

Computational Fluid Dynamics

SG:

Stent Graft

CTA:

Computed Tomography Angiography

WSS:

Wall Shear Stress

OSI:

Oscillatory Shear Index

ECAP:

Endothelial Cell Activation Potential

LSA:

Left Subclavian Artery

LCA:

Left Common Carotid Artery

BCA:

Brachiocephalic Artery

DAo:

Descending Aorta

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Acknowledgments

This work was supported by the Sichuan Province Science and Technology Support plan [Grant Nos. 2019YJ0026 and 2018YYJC]; the National Natural Science Foundation of China [Grant No. 81770471].

Funding

This work was supported by the Sichuan Province Science and Technology Support plan [Grant Nos. 2019YJ0026 and 2018YYJC]; the National Natural Science Foundation of China [Grant No. 81770471].

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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Authors and Affiliations

  1. Department of Applied Mechanics, Sichuan University, Chengdu, 610065, China

    Yue Qiu, Shiming Dong, Zhan Liu & Tinghui Zheng

  2. Department Vascular Surgery of West China Hospital, Sichuan University, Chengdu, 610041, China

    Ding Yuan

Authors
  1. Yue Qiu
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  2. Shiming Dong
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  3. Zhan Liu
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  4. Ding Yuan
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Correspondence to Ding Yuan or Tinghui Zheng.

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Associate Editor Francesco Migliavacca oversaw the review of this article.

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Qiu, Y., Dong, S., Liu, Z. et al. Effect of Geometric Accuracy at the Proximal Landing Zone on Simulation Results for Thoracic Endovascular Repair Patients. Cardiovasc Eng Tech 11, 679–688 (2020). https://doi.org/10.1007/s13239-020-00498-4

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