股腘“双通”手术血流动力学应用有限元分析方法

D. Nikolić, Dragan B. Sekulic, D. Milasinovic, D. Paunovic, Igor Sekulic, I. Šaveljić, N. Filipovic
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摘要

股骨-腘动脉“旁路”是指外周动脉闭塞疾病的晚期。手术治疗的适应症是根据临床表现、“踝臂指数”和血管造影结果确定的。通过有限元分析的方法,可以在扫描血管造影的基础上建立三维模型,在此基础上测量不同的物理量,计算出“踝臂指数”的值。目的是通过基于术前和术后血管扫描成像的有限元分析(FEA)方法以及可以通过这种方式测量的物理量来显示动脉的血流动力学。在这篇综述中,在术前和术后模型上介绍股腘“旁路”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。压力,“踝肱指数”,与患者的测量值进行比较,术前和术后的FEA结果。术后,在患者和模型上测量较高的压力值和“踝肱指数”。模型中显示的值与患者的测量值显著相关。切应力和速度值在术后模型上显著降低。流线显示优势胫骨前动脉。在病人身上测量到的物理量值和用有限元法得到的模型上的物理量值有很大的相关性。
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Hemodynamics of Femoro-Popliteal “Bi-Pass” Surgery using FEA Methods
Femoro-popliteal “by-pass” is indicated in the advanced stage of peripheral arterial occlusive disease. Indications for surgical treatment are set on the basis of the clinical picture, “ankle-brachial index” and angiographic findings. By the method of finite element analysis, three-dimensional models can be made on the basis of scanning angiography, on which we can measure different physical quantities and calculate the value of the “ankle-brachial index”. The aim is to show the hemodynamics of arteries by the method of finite element analysis (FEA) based on preoperative and postoperative scan angiography as well as physical quantities that can be measured in this way. In this review, the hemodynamics of femoro-popliteal “by-pass” on the preoperative and postoperative model are presented. The models obtained by FEA show: pressure, shear stress, velocities, and streamlines. Pressure, “ankle-brachial index”, compared with the values measured on the patient, with FEA results preoperatively and postoperatively. Postoperatively, higher values of pressure and “ankle-brachial index” were measured on the patient and on the models. The values shown in the models are significantly correlated with the values measured on the patient. Shear stress and velocity values are significantly reduced on postoperative models. The streamlines show a dominant anterior tibial artery. The values of physical quantities measured on the patient and on the models obtained by the FEA method correlate to a significant extent.
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