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Endograft-specific hemodynamics after endovascular aneurysm repair: a CFD analysis
Yuansu Zhang1, Deyin Zhao2, Xiaomao Si3
1Department of Vascular Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
Scientific Reports
|December 29, 2024
Summary
Endograft compression and distortion after EVAR may cause intraluminal prosthetic graft thrombus (IPT). Longer stents have minimal impact on blood flow, suggesting compression and distortion are key risk factors for IPT.
Area of Science:
- Biomedical Engineering
- Cardiovascular Science
- Medical Imaging
Background:
- Intraluminal prosthetic graft thrombus (IPT) is a complication of endovascular aortic repair (EVAR).
- Understanding hemodynamic changes associated with EVAR anatomical variations is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate hemodynamic indicators in different anatomical morphologies post-EVAR.
- To identify risk factors for IPT and provide references for clinical therapy.
Main Methods:
- Computational fluid dynamics (CFD) simulations were performed on six models: normal, iliac compression, aortic compression, aortoiliac compression, iliac distortion, and long-leg stent.
- Key hemodynamic parameters including flow velocity, time-average wall shear stress (TAWSS), oscillatory shear stress index (OSI), and relative residence time (RRT) were analyzed.
Main Results:
- Aortic and iliac artery compression models showed significant decreases in peak blood flow velocity (30.63%–48.62%) compared to the normal model.
- Iliac distortion led to reduced flow velocity (7.89% in aorta, 41.13% in iliac artery).
- Higher OSI and longer RRT were observed in aortoiliac compression and iliac distortion models, indicating potential thrombus formation sites.
Conclusions:
- Endograft compression and distortion are potential risk factors for intraluminal prosthetic graft thrombus (IPT).
- Stent length has a negligible effect on intra-stent hemodynamics.
- Further clinical studies are needed to validate these findings.
