Key result
Omission of the four visceral arteries of the abdominal aorta in computational models of type B aortic dissection after TEVAR results in incorrect prediction of flow direction and volume to the false lumen.
Why the study?
Branch arteries are often neglected in flow simulations of patient-specific type B aortic dissection after TEVAR due to difficulty obtaining patient-specific flow data.
Does the omission of aortic branch arteries in computational models affect the prediction of hemodynamics in type B aortic dissection following TEVAR?
Does the omission of aortic branch arteries in computational models affect the prediction of hemodynamics in type B aortic dissection following TEVAR?
Aortic branch arteries, particularly the visceral arteries of the abdominal aorta, must be included in computational models of type B aortic dissection after TEVAR to accurately predict hemodynamics and potential false lumen thrombosis.
Neglecting branch arteries may bias post-TEVAR AD flow simulations; leaves open impact on patient-specific risk assessment.
Objective Because of the difficulty in obtaining patient specific flow data, branch arteries are often neglected in the flow simulations of a patient-specific type B aortic dissection (AD) following thoracic endovascular repair (TEVAR). This study aims to investigate the influence of the aortic branch arteries on the hemodynamics and physical flow phenomena commonly associated with aortic modeling of an AD after TEVAR. Methods The three-dimensional geometry of a type B AD following TEVAR was generated from a high-quality CT dataset. Simulations were performed with all branch arteries, without the four visceral arteries of the abdominal aorta (FVAoAA), and without the upper three branches of the aortic arch (UTBoAA). Results The removal of the UTBoAA has marginal effect on the flow patterns and hemodynamic parameters in the false lumen (FL); however, regardless of whether there are aorta branches supplied to the FL or not, the omission of FVAoAA will result in a wrong prediction of the flow direction at tears and flow volume to the FL. Conclusions The omission of aorta branch arteries has great impact on the hemodynamic prediction including flow field and wall shear stress related parameters in a type B AD after TEVAR, which may induce misleading estimates of the potential thrombus in the FL. It is strongly recommended to keep aorta branches in the computational model to predict the post-operative hemodynamic performance in a type B AD following TEVAR.
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Jiang et al. (2019) studied Type B aortic dissection following TEVAR (n=1). Omission of aortic branch arteries in computational models vs. Simulation with all branch arteries included was evaluated on Hemodynamics and physical flow phenomena (flow direction, flow volume, wall shear stress). Omission of the four visceral arteries of the abdominal aorta in computational models of type B aortic dissection after TEVAR results in incorrect prediction of flow direction and volume to the false lumen.
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