Contemporary Role of Computational Analysis in Endovascular Treatment for Thoracic Aortic Disease

AORTA

article

Guido H.W. van Bogerijen¹  Santi Trimarchi¹  Jip L. Tolenaar¹  Michele Conti²  Ferdinando Auricchio²  Francesco Secchi³  Francesco Sardanelli³  Frans L. Moll⁴  Joost A. van Herwaarden⁴  Vincenzo Rampoldi¹ 

[1] Thoracic Aortic Research Center, University of Milan;Department of Civil Engineering and Architecture, Structural Mechanics Division, University of Pavia;Department of Radiology, University of Milan;Department of Vascular Surgery, University Medical Center Utrecht

关键词: Thoracic endovascular aortic repair (TEVAR);    thoracic aortic disease;    Computational analysis;   

DOI  :  10.12945/j.aorta.2013.13-003

来源: Thieme

【 摘 要 】

In the past decade, thoracic endovascular aortic repair (TEVAR) has become the primary treatment option in descending aneurysm and dissection. The clinical outcome of this minimally invasive technique is strictly related to an appropriate patient/stent graft selection, hemodynamic interactions, and operator skills. In this context, a quantitative assessment of the biomechanical stress induced in the aortic wall due to the stent graft may support the planning of the procedure. Different techniques of medical imaging, like computed tomography or magnetic resonance imaging, can be used to evaluate dynamics in the thoracic aorta. Such information can also be combined with dedicated patient-specific computer-based simulations, to provide a further insight into the biomechanical aspects. In clinical practice, computational analysis might show the development of aortic disease, such as the aortic wall segments which experience higher stress in places where rupture and dissection may occur. In aortic dissections, the intimal tear is usually located at the level of the sino-tubular junction and/or at the origin of the left subclavian artery. Besides, computational models may potentially be used preoperatively to predict stent graft behavior, virtually testing the optimal stent graft sizing, deployment, and conformability, in order to provide the best endovascular treatment. The present study reviews the current literature regarding the use of computational tools for TEVAR biomechanics, highlighting their potential clinical applications.

【 授权许可】

Unknown