Hemodynamic Performance of Multilayer Stents in the Treatment of Aneurysms with a Branch Attached

Sci Rep. 2019 Jul 15;9(1):10193. doi: 10.1038/s41598-019-46714-7.

Abstract

Although multilayer stents (MSs) can be used to treat aneurysm effectively, for some aneurysms with branches attached, the hemodynamic mechanisms are still unclear. In this work, we modeled five cases that involve 1-4-layer stents implanted in aneurysms with side branches, and the numerical approach was used. Case 1 corresponds to an aneurysm without a stent, and cases 2-5 represent 1-4-layer stents being employed within aneurysms, respectively. The results showed that the velocity within the sac declined dramatically and the eddies' intensity weakened with increased number of stent layers, time-averaged wall shear stress (TAWSS), and nitric oxide production rate (TARNO) dropped linearly with increase in stent porosity, and oscillatory shear index (OSI) and relative residence time (RRT) increased evidently with MS intervention. Moreover, the MSs had a slight effect on the patency of the side branch; its flow rate was still above the normal case than without aneurysm. It can be concluded that MSs are helpful in promoting the growth of thrombus within the aneurysm through an isolated hemodynamic environment and keeping the branch unobstructed, but more clinical evidences are required.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aneurysm / therapy*
  • Aortic Aneurysm, Thoracic / surgery
  • Blood Vessel Prosthesis Implantation / methods*
  • Computer Simulation
  • Endovascular Procedures / methods
  • Hemodynamics / physiology
  • Humans
  • Models, Biological
  • Models, Cardiovascular
  • Models, Statistical
  • Stents / trends*
  • Stress, Mechanical