Hemodynamic Analysis to Assist Treatment Strategies in Complex Visceral Arterial Pathologies: Case Reports and discussion from Pancreaticoduodenal Artery Aneurysm with Superior Mesenteric Artery Occlusion.
Ann Vasc Surg
; 59: 308.e1-308.e8, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-31075464
ABSTRACT
BACKGROUND:
Pancreaticoduodenal artery aneurysms (PDAAs) with occlusion of the superior mesenteric artery (SMA) are extremely rare. In the present study, we used computational fluid dynamics (CFD) to analyze the hemodynamics of a patient-specific PDAA with occlusion of the SMA preoperatively and then decide the treatment strategy in terms of the potential postoperative hemodynamics.METHODS:
A 3D model of a 69-old-year female with PDAA was reconstructed based on CT images. The virtual postoperative models of the aneurysmectomy with or without revascularization were numerically simulated in terms of hemodynamics including the flow field and wall shear stress (WSS).RESULTS:
Aneurysmectomy with revascularization would result in the original aneurysm site experiencing abnormally high WSS and pressure, which may possibly lead to the recurrence of PDAA. However, aneurysmectomy without revascularization would lead to stagnant flow in the blocked posterior-inferior pancreaticoduodenal artery (PIPDA). As a result, the PIPDA may soon be completely occluded after surgery and the SMA perfusion would be guaranteed. Finally, aneurysmectomy without revascularization was performed in this patient. The postoperative six-month computed tomography angiography result finely matched to the preoperative CFD simulation result.CONCLUSIONS:
This study gained insights into hemodynamics of PDAA. In addition, it demonstrated that utilization of CFD analysis also possibly helps assist the operation strategies for vascular diseases.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Pâncreas
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Circulação Esplâncnica
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Artéria Mesentérica Superior
/
Duodeno
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Modelagem Computacional Específica para o Paciente
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Hemodinâmica
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Aneurisma
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Oclusão Vascular Mesentérica
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
Idioma:
En
Revista:
Ann Vasc Surg
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
China