TY - JOUR
T1 - Geometric analysis of type b aortic dissections shows aortic remodeling after intervention using multilayer stents
AU - Costache, Victor S.
AU - Meekel, Jorn P.
AU - Costache, Andreea
AU - Melnic, Tatiana
AU - Solomon, Crina
AU - Chitic, Anca M.
AU - Bucurenciu, Cristian
AU - Moldovan, Horatiu
AU - Antoniac, Iulian
AU - Candea, Gabriela
AU - Yeung, Kak K.
N1 - Funding Information: Funding: This paper/research is supported by the Competitiveness Operational Program 2014–2020, financed from European Regional Development Fund and by the Romanian Government under the project “Next generation computer-aided research in cardiovascular disease management –NextCARDIO”, project code: COP P_37_701. Publisher Copyright: © 2020 by the authors. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Recently, multilayer stents for type B aortic dissections (TBAD) have been proposed to decrease false lumen flow, increase and streamline true lumen flow, and retain branch vessel patency. We aimed to provide a protocol with standardized techniques to investigate aortic remodeling of TBAD by multilayer flow modulators (MFM) in static geometric and hemodynamic analyses. Combining existing literature and new insights, a standardized protocol was designed. Using preand postoperative CT scans, geometric models were constructed, lumen dimensions were calculated, computational fluid dynamics (CFD) models were composed, and velocity and pressures were calculated. Sixteen TBAD cases treated with MFM were included for analysis. For each case, aortic remodeling was analyzed using post-processing medical imaging software. After 3D models were created, geometrical anatomical measurements were performed, and meshes for finite element analysis were generated. MFM cases were compared pre- and postoperatively; true lumen volumes increased (p < 0.001), false lumen volumes decreased (p = 0.001), true lumen diameter at the plane of maximum compression (PMC) increased (p < 0.001), and false lumen index decreased (p = 0.008). True lumen flow was streamlined, and the overall fluid velocity and pressures decreased (p < 0.001 and p = 0.006, respectively). This protocol provided a standardized method to evaluate the effects of MFM treatments in TBAD on geometric analyses, PMC, and CFD outcomes.
AB - Recently, multilayer stents for type B aortic dissections (TBAD) have been proposed to decrease false lumen flow, increase and streamline true lumen flow, and retain branch vessel patency. We aimed to provide a protocol with standardized techniques to investigate aortic remodeling of TBAD by multilayer flow modulators (MFM) in static geometric and hemodynamic analyses. Combining existing literature and new insights, a standardized protocol was designed. Using preand postoperative CT scans, geometric models were constructed, lumen dimensions were calculated, computational fluid dynamics (CFD) models were composed, and velocity and pressures were calculated. Sixteen TBAD cases treated with MFM were included for analysis. For each case, aortic remodeling was analyzed using post-processing medical imaging software. After 3D models were created, geometrical anatomical measurements were performed, and meshes for finite element analysis were generated. MFM cases were compared pre- and postoperatively; true lumen volumes increased (p < 0.001), false lumen volumes decreased (p = 0.001), true lumen diameter at the plane of maximum compression (PMC) increased (p < 0.001), and false lumen index decreased (p = 0.008). True lumen flow was streamlined, and the overall fluid velocity and pressures decreased (p < 0.001 and p = 0.006, respectively). This protocol provided a standardized method to evaluate the effects of MFM treatments in TBAD on geometric analyses, PMC, and CFD outcomes.
KW - Aortic dissection
KW - Aortic remodeling
KW - Computational fluid dynamics
KW - Geometric analysis
KW - Multilayer flow modulator
UR - http://www.scopus.com/inward/record.url?scp=85085244205&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/ma13102274
DO - https://doi.org/10.3390/ma13102274
M3 - Article
C2 - 32429089
SN - 1996-1944
VL - 13
JO - Materials
JF - Materials
IS - 10
M1 - 2274
ER -