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Impact of Cross-Limb Stent-Graft Configuration on Hemodynamics in Abdominal Aortic Aneurysm Interventional Therapy

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Abstract

Purpose

The cross-limb (CL) technique is a commonly used endovascular treatment for addressing unfavorable anatomical features in patients with abdominal aortic aneurysm (AAA). The configuration of CL stent-graft plays a critical role in determining the postoperative hemodynamic properties and physiological behaviors, which ultimately impact the efficacy and safety of endovascular AAA treatment. This study aims to investigate the relationship between hemodynamics and CL stent-graft configuration from a hemodynamic perspective.

Methods

Five distinct geometric models of cross-limb (CL) stent-graft configurations were constructed by optimizing the real clinical computed tomography angiography (CTA) data. These models varied in main body lengths and cross angles and were used to perform numerical simulations to analyze various hemodynamic parameters. Flow pattern, distribution of wall shear stress (WSS)-related parameters, localized normalized helicity (LNH), pressure drop, and the displacement force of all models were examined in this paper.

Results

In patient-specific cases, helical flow and WSS increase with the main body. However, it also generated secondary flow in localized areas, leading to increased oscillation in the WSS direction. Notably, increasing the stent graft’s main body length or decreasing the cross angle reduced the displacement force exerted on the stent-graft. Reducing the cross angle did not significantly alter the hemodynamic characteristics.

Conclusion

In the clinical practice of CL deployment, it is crucial to carefully consider the stent-graft configuration and the patient specific to achieve optimal postoperative outcomes. This study provides valuable insights for guiding stent selection and treatment planning in patients with abdominal aortic aneurysm undergoing CL techniques, from a hemodynamic perspective.

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Data Availability

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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Funding

This work was funded by Open Foundation of Institute of Human Biomechanics, Ningbo University (CJ-HBIO202103), National Natural Science Foundation of China [12002231], the Beijing Municipal Natural Science Foundation [7212095], Ningbo Natural Science Foundation (2021J240), “1331 project” Key Innovation Teams of Shanxi Province, and Central Guidance on Local Science and Technology Development Found of Shanxi Province (YDZJSX2021A021).

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Author notes

  1. Yanqing Xie and Yating Zhu have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China

    Yanqing Xie

  2. Department of Vascular Surgery, First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

    Yating Zhu, Hongpeng Zhang & Wei Guo

  3. College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China

    Yike Shi, Yawei Zhao & Lingfeng Chen

  4. College of Mechanical and Vehicle Engineering, Taiyuan University of Technology, 79 West Yingze Street, Taiyuan, 030024, China

    Fen Li & Hui Song

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  1. Yanqing Xie
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Contributions

YX: contributed to writing part of original draft, YZ and HZ: contributed to the design of the study, YS and YZ: contributed to processing the results of the calculation, FL: designing of the study and reconstructed the CADs, HS: performed the numerical simulation, LC: validated the numerical results, WG: co-supervised the research. All authors have read and agreed to the published version of the manuscript.

Corresponding authors

Correspondence to Fen Li or Wei Guo.

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Associate Editor Alison Marsden, Ph.D. oversaw the review of this article.

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Xie, Y., Zhu, Y., Shi, Y. et al. Impact of Cross-Limb Stent-Graft Configuration on Hemodynamics in Abdominal Aortic Aneurysm Interventional Therapy. Cardiovasc Eng Tech (2023). https://doi.org/10.1007/s13239-023-00702-1

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