Computational Fluid Analysis of Blood Flow Characteristics in Abdominal Aortic Aneurysms Treated with Suprarenal Endovascular Grafts

The purpose of this study is to investigate the hemodynamic effects of suprarenal stent grafts on the renal arteries in the treatment of patients with abdominal aortic aneurysm. Suprarenal stent grafts have been increasingly used for treatment of aortic aneurysms with suboptimal aneurysm necks. However, the long-term safety of this procedure is yet to be determined. 2 sample patients undergoing suprarenal stent grafting were included in the study. Four variable configurations of stent wires crossing the renal artery ostium were simulated in aorta models based on CT generated data, at different cardiac cycles. The stent wires thickness was set 0.5 mm which is similar to the actual diameter of a stent wire. Computational fluid dynamic analysis showed slightly decrease of flow velocity to the renal arteries with multiple wires crossing, and no changes of flow velocity to the renal arteries with single wire crossing. Our preliminary results demonstrated the safety of suprarenal stent grafting. Further studies are required to investigate the effect of different wire thickness on subsequent hemodynamic changes to the renal arteries.

[1]  G. Moneta,et al.  Comparison of Endovascular Aneurysm Repair With Open Repair in Patients With Abdominal Aortic Aneurysm (EVAR Trial 1), 30-Day Operative Mortality Results: Randomised Controlled Trial , 2006 .

[2]  Zhonghua Sun,et al.  Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology. , 2007, Journal of vascular surgery.

[3]  P. Bendick,et al.  Transrenal fixation of aortic stent-grafts for the treatment of infrarenal aortic aneurysmal disease. , 2000, Journal of vascular surgery.

[4]  M. Douglas,et al.  Transrenal Fixation of Aortic Endografts: Intermediate Follow-up of a Single-Center Experience , 2000, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[5]  J. McKinney,et al.  Effect of suprarenal versus infrarenal aortic endograft fixation on renal function and renal artery patency: a comparative study with intermediate follow-up. , 2003, Journal of vascular surgery.

[6]  Erik Buskens,et al.  A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. , 2004, The New England journal of medicine.

[7]  Simon Wildermuth,et al.  Computational Fluid Dynamics: Hemodynamic Changes in Abdominal Aortic Aneurysm After Stent-Graft Implantation , 2006, CardioVascular and Interventional Radiology.

[8]  Cross-sectional area reduction of the aortic ostium by suprarenal stent wires: in vitro phantom study by CT virtual angioscopy. , 2004, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[9]  S. Haulon,et al.  Analysis of renal function after aneurysm repair with a device using suprarenal fixation (Zenith AAA Endovascular Graft) in contrast to open surgical repair. , 2004, Journal of vascular surgery.

[10]  Elena S. Di Martino,et al.  Fluid-structure interaction within realistic three-dimensional models of the aneurysmatic aorta as a guidance to assess the risk of rupture of the aneurysm. , 2001, Medical engineering & physics.

[11]  R. J. Winder,et al.  CT virtual intravascular endoscopy of abdominal aortic aneurysms treated with suprarenal endovascular stent grafting , 2003, Abdominal Radiology.

[12]  Peter L Harris,et al.  Outcome of endovascular abdominal aortic aneurysm repair in patients with conditions considered unfit for an open procedure: a report on the EUROSTAR experience. , 2002, Journal of vascular surgery.

[13]  Kurt Liffman,et al.  Suprarenal fixation: effect on blood flow of an endoluminal stent wire across an arterial orifice. , 2003, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.