Key result
Computational simulations revealed that proximal endoleaks significantly weaken the pressure shielding ability of stent-grafts throughout the cardiac cycle compared to middle or distal endoleaks.
Computational modeling demonstrates that proximal endoleaks after EVAR severely compromise the pressure shielding ability of stent-grafts throughout the cardiac cycle, posing a higher risk for AAA re-enlargement.
Proximal endoleaks may increase AAA re-enlargement risk after EVAR; computational findings leave open clinical validation.
BACKGROUND: Abdominal aortic aneurysm (AAA) is a kind of dangerous aortic vascular disease, which is characterized by abdominal aorta partial enlargement. At present, endovascular aneurysm repair (EVAR) is one of the main treatments of abdominal aortic aneurysm. However for some patients after EVAR the aneurysm re-expanded and even ruptured, leading to poor postoperative effect. The stent-graft endoleak after EVAR was realized to influence the AAA in-sac pressure and contribute to the aneurysm re-enlargement. METHODS: In order to analyze the influence of endoleaks positions on the pressure shielding ability of stent-graft after EVAR, type I and type III endoleak models were reconstructed based on computed tomography (CT) scan images, and the hemodynamic environment in AAA was numerically simulated. RESULTS: When the endoleak was at the proximal position the pressure shielding ability will be obviously weakened. While, the pressure shielding ability was higher in the systole phase than that in diastole phase when the endoleak located at the middle or distal positions. Unfortunately, when the endoleak located at the proximal position, the pressure shielding ability would be relatively weak in the whole cardiac cycle. CONCLUSIONS: The results revealed that the influence of endoleaks on pressure shielding ability of stent-graft was both location and time specific.
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Li et al. (2016) studied Abdominal aortic aneurysm (AAA). Endoleak position vs. Different endoleak positions was evaluated on Pressure difference between aortic inlet and AAA wall (pressure shielding ability). Computational simulations revealed that proximal endoleaks significantly weaken the pressure shielding ability of stent-grafts throughout the cardiac cycle compared to middle or distal endoleaks.
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