The necessity to seal the re-entry tears of aortic dissection after TEVAR: a hemodynamic indicator
Author(s)
Type
Journal Article
Abstract
Thoracic endovascular aortic repair (TEVAR) is a common treatment for Stanford type B aortic dissection (TBAD). However, re-entry tears might be found distal to the stented region which transports blood between the true and false lumens. Sealing the re-entry tears, especially for the thoracic tears, could further reduce blood perfusion to the false lumen; however, it might also bring risks by re-intervention or surgery. Wise determination of the necessity to seal the re-entry tears is needed. In this study, patient-specific models of TBAD were reconstructed, and the modified models were established by virtually excluding the thoracic re-entries. Computational hemodynamics was investigated, and the variation of the functional index and first balance position (FBP) of the luminal pressure difference, due to the sealing of the re-entries, was reported. The results showed that the direction of the net flow through the unstented thoracic re-entries varied among cases. Excluding the re-entries with the net flow toward the false lumen may induce the FBP moving distally and the relative particle residence time increasing in the false lumen. This study preliminarily demonstrated that the hemodynamic status of the re-entry tears might serve as an indicator to the necessity of sealing. By quantifying the through-tear flow exchange and shift of FBP, one can predict the hemodynamic benefit by sealing the thoracic re-entries and thus wisely determine the necessity of further interventional management.
Date Issued
2022-03-31
Date Acceptance
2022-01-11
Citation
Frontiers in Bioengineering and Biotechnology, 2022, 10, pp.1-11
ISSN
2296-4185
Publisher
Frontiers Media
Start Page
1
End Page
11
Journal / Book Title
Frontiers in Bioengineering and Biotechnology
Volume
10
Copyright Statement
© 2022 Li, Xu, Armour, Guo, Xiong, Xu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000787988400001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Biotechnology & Applied Microbiology
Multidisciplinary Sciences
Science & Technology - Other Topics
aortic dissection
re-entry tear
modified models
hemodynamic indicator
re-intervention or surgery
FALSE LUMEN THROMBOSIS
ENDOVASCULAR REPAIR
INTERNATIONAL REGISTRY
COMPUTATIONAL ANALYSIS
ENTRY TEARS
FLOW
GROWTH
ENLARGEMENT
PREDICTORS
DYNAMICS
Publication Status
Published
Article Number
ARTN 831903
Date Publish Online
2022-03-31