A Fenestrated Balloon Expandable Stent System for the Treatment of Aortoiliac Occlusive Disease.

John L Cashin, Alex J Wirtz, Guy M Genin, Mohamed Zayed
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Abstract

In aortoiliac occlusive disease, atherosclerotic plaques can occlude the distal aortic bifurcation and proximal bilateral iliac artery and thus cause ischemia in the lower extremity. This is typically treated by restoring patency with balloon expandable stents. Stents are typically deployed in a "kissing stent" configuration into the bilateral iliac arteries and into the distal aortic bifurcation lumen to restore antegrade arterial flow. However, these stents typically become re-occluded by plaques. To understand the reasons for this and look for solutions, we simulated flow dynamics in the aortic bifurcation in the presence and absence of stents using computational fluid dynamics. Results demonstrated that the kissing stent configuration was associated with high levels of vorticity and flow constriction. These prothrombotic variables were alleviated in an alternative, aortoiliac fenestrated (AIFEN), tapered, and balloon-expandable stent design. Our findings suggest that stent design can be tailored to improve flow fields for aortoiliac stenting.

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开窗球囊可扩张支架系统治疗主动脉髂闭塞性疾病。
在髂主动脉闭塞性疾病中,动脉粥样硬化斑块可闭塞主动脉远端分支和双侧髂近端动脉,从而引起下肢缺血。典型的治疗方法是使用球囊扩张支架恢复通畅。支架通常以“吻合器支架”的形式放置于双侧髂动脉和主动脉分叉远端管腔内,以恢复顺行动脉血流。然而,这些支架通常会被斑块重新阻塞。为了了解造成这种情况的原因并寻找解决方案,我们使用计算流体动力学模拟了在存在和不存在支架的情况下主动脉分叉的血流动力学。结果表明,接吻支架结构与高水平的涡度和血流收缩有关。这些血栓形成前的变量在另一种选择中得到缓解,即主动脉髂开窗(AIFEN)、锥形和球囊可扩张支架设计。我们的研究结果表明,支架设计可以量身定制,以改善主动脉髂支架置入的流场。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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