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A computational model for false lumen thrombosis in type B aortic dissection following thoracic endovascular repair

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Title: A computational model for false lumen thrombosis in type B aortic dissection following thoracic endovascular repair
Authors: Menichini, C
Cheng, Z
Gibbs, RGJ
Xu, XY
Item Type: Journal Article
Abstract: Thoracic endovascular repair (TEVAR) has recently been established as the preferred treatment option for complicated type B dissection. This procedure involves covering the primary entry tear to stimulate aortic remodelling and promote false lumen thrombosis thereby restoring true lumen flow. However, complications associated with incomplete false lumen thrombosis, such as aortic dilatation and stent graft induced new entry tears, can arise after TEVAR. This study presents the application and validation of a recently developed mathematical model for patient-specific prediction of thrombus formation and growth under physiologically realistic flow conditions. The model predicts thrombosis through the evaluation of shear rates, fluid residence time and platelet distribution, based on convection-diffusion-reaction transport equations. The model was applied to 3 type B aortic dissection patients: two TEVAR cases showing complete and incomplete false lumen thrombosis respectively, and one medically treated dissection with no signs of thrombosis. Predicted thrombus growth over time was validated against follow-up CT scans, showing good agreement with in vivo data in all cases with a maximum difference between predicted and measured false lumen reduction below 8%. Our results demonstrate that TEVAR-induced thrombus formation in type B aortic dissection can be predicted based on patient-specific anatomy and physiologically realistic boundary conditions. Our model can be used to identify anatomical or stent graft related factors that are associated with incomplete false lumen thrombosis following TEVAR, which may help clinicians develop personalised treatment plans for dissection patients in the future.
Issue Date: 3-Nov-2017
Date of Acceptance: 28-Oct-2017
URI: http://hdl.handle.net/10044/1/53102
DOI: https://dx.doi.org/10.1016/j.jbiomech.2017.10.029
ISSN: 0021-9290
Publisher: Elsevier
Start Page: 36
End Page: 43
Journal / Book Title: Journal of Biomechanics
Volume: 66
Copyright Statement: © 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Aortic dissection
CFD
False lumen
Hemodynamics
TEVAR
Thrombosis
0903 Biomedical Engineering
1106 Human Movement And Sports Science
0913 Mechanical Engineering
Biomedical Engineering
Publication Status: Published
Appears in Collections:Faculty of Engineering
Division of Surgery
Chemical Engineering
Faculty of Medicine



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