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Endografts, pressure, and the abdominal aortic aneurysm.

机译:内移植物,压力和腹主动脉瘤。

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摘要

Abdominal aortic aneurysms (AAA) are an expansion in diameter of the abdominal aorta and their rupture is a leading cause of mortality. One of the treatments for AAA is the implantation of an endograft (also called a stent graft), a combination of fabric and metal stents, to provide a new conduit for blood and shield the aneurysm sac from direct pressurization. After implantation of the stent graft, the aneurysm may shrink, grow, or stabilize in diameter---even in the absence of apparent flow into the sac---in some cases resulting in graft failure through component separation, kinking, or loss of seal at its ends.;Greater understanding of AAA and treated AAA could provide insight on how treatment might be modified to improve treatment methods and/or design devices to be more effective in a wider range of patients. Computational models provide a means to investigate the biomechanics of endografts treating AAA through analysis of the endografts, the AAA, and the combination of them.;Axisymmetric models of endograft-treated AAA showed that peak von Mises stress within the wall varied between 533 kPa and 1200 kPa when different material properties for the endograft were used. The patient-specific models, built from time series of patient CT scans with similar patient history but different outcomes, show that wall shrinkage and stability can be related to the level of stresses within the vessel wall, with the shrinking AAA showing a greater reduction by endograft treatment and a lower final value of average von Mises stress. The reduction in pressure felt by the wall is local to the central sac region. The inclusion of thrombus is also essential to accurate stress estimation.;The combination of axisymmetric and patient-specific computational models explains in further detail the biomechanics of endograft treatment. The patient-specific reconstruction models show that when effectively deployed and reducing the pressure felt in the AAA wall, the graft is under tension in the sac region and compression at its ends.
机译:腹主动脉瘤(AAA)是腹主动脉直径的扩大,其破裂是导致死亡的主要原因。 AAA的一种治疗方法是植入内移植物(也称为支架移植物),即织物和金属支架的组合,以提供新的血液导管并保护动脉瘤囊免受直接加压。植入支架移植物后,动脉瘤可能收缩,生长或直径稳定-甚至在没有明显流入囊腔的情况下-在某些情况下会因成分分离,扭结或丢失而导致移植失败对AAA和已治疗的AAA的更深入了解可以提供有关如何修改治疗方法以改善治疗方法和/或设计装置以在更广泛的患者中更有效的见解。计算模型提供了一种通过分析内移植物,AAA及其组合来研究内移植物治疗AAA的生物力学的方法。;内移植物处理的AAA的轴对称模型表明,壁内的von Mises峰值应力在533 kPa和当使用不同的材料特性进行内移植时为1200 kPa。根据具有相似患者历史但结果不同的患者CT扫描的时间序列建立的特定于患者的模型表明,壁的收缩和稳定性可能与血管壁内的应力水平有关,而AAA的收缩显示出更大的降低。内移植治疗,平均von Mises应力的最终值较低。壁所感觉到的压力降低在中央囊区域内是局部的。血栓的形成对于准确估计压力也至关重要。轴对称和特定于患者的计算模型的结合进一步详细说明了内移植治疗的生物力学。特定于患者的重建模型显示,当有效展开并降低AAA壁中的压力时,移植物在囊区域处于拉伸状态,并在其末端受到压缩。

著录项

  • 作者

    Meyer, Clark Andrew.;

  • 作者单位

    Texas A&M University.;

  • 授予单位 Texas A&M University.;
  • 学科 Engineering Biomedical.
  • 学位 Ph.D.
  • 年度 2009
  • 页码 193 p.
  • 总页数 193
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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