Haemodynamics of femoropopliteal bypass surgery using finite element analysis method

Q4 Medicine Medicinski Casopis Pub Date : 2021-01-01 DOI:10.5937/mckg55-31632
Dragan B. Sekulic, A. Tomić, D. Milasinovic, D. Nikolić, D. Paunovic, Uros M. Miladinovic, Igor Sekulic, Maja Savić-Sekulić, B. Milev
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Abstract

Objective. Femoropopliteal bypass is indicated in the advanced stage of peripheral arterial occlusive disease. The indications for surgical treatment are determined on the basis of a clinical exam, "ankle-brachial index" and angiographic findings. Using the finite element analysis method, three-dimensional models can be made based on angiography, and these models can be used to measure different physical quantities and calculate the value of the "ankle-brachial index". The aim of this paper is to show the hemodynamics of arteries by using the finite element analysis method based on preoperative and postoperative angiography, as well as physical quantities that can be measured in this way. Methods. This case shows the hemodynamics of femoropopliteal bypass in the preoperative and postoperative models. The models obtained by finite element analysis show: pressure, shear stress, velocities, and streamlines. The pressure, i.e. the "ankle-brachial index", was compared with the values measured on the patient, while the other three values were compared preoperatively and postoperatively. Results. Postoperatively, higher values of pressure and "ankle-brachial index" were measured on the patient and on the models. Wall shear stress and velocity values were reduced in postoperative models. The streamlines showed a dominant anterior tibial artery. Conclusion. The values of physical quantities measured on patient and on the models obtained by the finite element analysis method correlate significantly. Some physical quantities could indicate the "weak points" of a particular model.
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股腘动脉搭桥手术血流动力学的有限元分析方法
目标。股腘动脉旁路术适用于外周动脉闭塞性疾病的晚期。手术治疗的适应症是根据临床检查、“踝臂指数”和血管造影结果确定的。利用有限元分析方法,可以在血管造影的基础上建立三维模型,这些模型可以用来测量不同的物理量,计算“踝臂指数”的值。本文的目的是利用基于术前和术后血管造影的有限元分析方法来显示动脉的血流动力学,以及由此可以测量到的物理量。方法。本病例显示了股腘动脉旁路术前和术后模型的血流动力学。通过有限元分析得到的模型显示:压力、剪应力、速度和流线。将压力即“踝肱指数”与患者的测量值进行比较,并将术前和术后的其他三个值进行比较。结果。术后,在患者和模型上测量较高的压力值和“踝肱指数”。术后模型中壁剪应力和速度值降低。流线显示胫骨前动脉占主导地位。结论。在病人身上测量的物理量值与有限元分析方法得到的模型上的物理量值有显著的相关性。一些物理量可以指出一个特定模型的“弱点”。
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Medicinski Casopis
Medicinski Casopis Medicine-Medicine (all)
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