Endovascular treatment of the femoro-popliteal artery has recently become a valuable therapeutic option for popliteal arterial aneurysms.However,its efficacy remains controversial due to the relatively high rate of co...Endovascular treatment of the femoro-popliteal artery has recently become a valuable therapeutic option for popliteal arterial aneurysms.However,its efficacy remains controversial due to the relatively high rate of complications,such as stent occlusion as result of intra-stent thrombosis.The elucidation of the interplay among vessel geometrical features,local hemodynamics,and leg bending seems crucial to understand onset and progression of popliteal intra-stent thrombosis.To this aim,patient-specific computational fluid dynamic simulations were performed in order to assess the intra-stent hemodynamics of two patients endovascularly treated for popliteal arterial aneurysm by stent-grafts and experiencing intra-stent thrombosis.Both Newtonian and non-Newtonian blood rheological models were considered.Results were presented in terms of tortuosity,luminal area exposed to low(<0.4 Pa)and high(>1.5 Pa)time-averaged wall shear stress(TAWSS),area exposed to high(>0.3)oscillatory shear index(OSI),and flow helicity.Study outcomes demonstrated that leg bending induced significant hemodynamic differences(>50%increase)in both patients for all the considered variables,except for OSI in one of the two considered patients.In both leg configurations,stent-graft overlapping induced a severe discontinuity of the lumen diameter where the proximal stented zone is characterized by low tortuosity,low velocity,low helicity,low TAWSS,and high OSI;while the distal part has higher tortuosity,velocity,helicity,TAWSS,and lower OSI.Sensitivity study on applied boundary conditions showed that the different inlet velocity profiles for a given inlet waveform affect slightly the numerical solution;conversely,the shape and magnitude of the prescribed inlet waveform is determinant.Focusing on the comparison between the Newtonian and non-Newtonian blood models,the area with low TAWSS is greater in the Newtonian model for both patients,while no significant difference occurs between the surfaces with high TAWSS.展开更多
In the original publication of the article a fund note has not been displayed appropriately in the acknowledgment section.The missing fund note is updated in this correction.
基金This work was partially supported by the“Pro-gramma Operativo Por FSE Regione Liguria 2014-2020”(RLOF18 A-SSRIC/38/1).
文摘Endovascular treatment of the femoro-popliteal artery has recently become a valuable therapeutic option for popliteal arterial aneurysms.However,its efficacy remains controversial due to the relatively high rate of complications,such as stent occlusion as result of intra-stent thrombosis.The elucidation of the interplay among vessel geometrical features,local hemodynamics,and leg bending seems crucial to understand onset and progression of popliteal intra-stent thrombosis.To this aim,patient-specific computational fluid dynamic simulations were performed in order to assess the intra-stent hemodynamics of two patients endovascularly treated for popliteal arterial aneurysm by stent-grafts and experiencing intra-stent thrombosis.Both Newtonian and non-Newtonian blood rheological models were considered.Results were presented in terms of tortuosity,luminal area exposed to low(<0.4 Pa)and high(>1.5 Pa)time-averaged wall shear stress(TAWSS),area exposed to high(>0.3)oscillatory shear index(OSI),and flow helicity.Study outcomes demonstrated that leg bending induced significant hemodynamic differences(>50%increase)in both patients for all the considered variables,except for OSI in one of the two considered patients.In both leg configurations,stent-graft overlapping induced a severe discontinuity of the lumen diameter where the proximal stented zone is characterized by low tortuosity,low velocity,low helicity,low TAWSS,and high OSI;while the distal part has higher tortuosity,velocity,helicity,TAWSS,and lower OSI.Sensitivity study on applied boundary conditions showed that the different inlet velocity profiles for a given inlet waveform affect slightly the numerical solution;conversely,the shape and magnitude of the prescribed inlet waveform is determinant.Focusing on the comparison between the Newtonian and non-Newtonian blood models,the area with low TAWSS is greater in the Newtonian model for both patients,while no significant difference occurs between the surfaces with high TAWSS.
文摘In the original publication of the article a fund note has not been displayed appropriately in the acknowledgment section.The missing fund note is updated in this correction.
