We have located links that may give you full text access.
Multilayer flow modulator enhances vital organ perfusion in type B aortic dissection patients.
Management of aortic dissections (AD) is still challenging, with no universally-approved guideline among possible surgical, endovascular or medical therapies. Approximately 25% of AD patients suffer post-intervention malperfusion syndrome or hemodynamic instability, with the risk of sudden death if left untreated. Part of the issue is that vascular implants may themselves induce flow disturbances that critically impact vital organs. A multilayer mesh construct might obviate the induced flow disturbances and it is this concept we investigated. We used pre-intervention (PI) and post-multilayer flow modulator (MFM) implantation (PM) geometries from clinical cases of type-B AD. In-house semi-automatic segmentation routines were applied to computed-tomography (CT) images to reconstruct the lumen. The device was numerically reconstructed and adapted to the PM geometry concentrically fit to the true lumen centerline. We also numerically designed a pseudo-healthy case (PH), where the geometry of the aorta was extracted interpolating geometrical features of PI, PM, and published representative healthy volunteers. Computational Fluid Dynamics (CFD) methods were used to study the time-dependent flow patterns, shear stress metrics and perfusion to vital organs. A three-element Windkessel lumped parameter module was coupled to a finite volume solver to assign dynamic outlet boundary conditions. MFM not only significantly reduces false lumen blood flow, eliminates local flow disturbances, and globally regulates WSS distribution; it also maintains physiologic perfusion to peripheral vital organs. We propose further investigation to focus the management of AD on both modulation of blood flow and restoration of physiologic end-organ perfusion rather than mere restoration of vascular lamina morphology.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app