Hemodynamic consequences of a multilayer flow modulator in aortic dissection.
Aortic dissections are challenging for it remains perplexing to determine when surgical, endovascular, or medical therapies are optimal. We studied the effect of the multilayer flow modulator (MFM) device in patients with different forms of type-B aortic dissections. CT scans were performed pre-, im...
| Publicado en: | Medical & Biological Engineering & Computing Vol. 57; no. 9; pp. 1861 - 1875 |
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| Autores principales: | , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Sep2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=138201467&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 138201467 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01400118 PO0 jtl: Medical & Biological Engineering & Computing issn: 01400118 maglogo: N pubinfo: dt: Sep2019 vid: 57 iid: 9 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 138201467 138201467 143931080 NLM31209712 10.1007/s11517-019-01997-w NLM31209712 138201467 ppf: 1861 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Hemodynamic consequences of a multilayer flow modulator in aortic dissection. aug: au: Athanasiou, Lambros S. Nezami, Farhad Rikhtegar Edelman, Elazer R. affil: Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA sug: subj: Blood Vessel Prosthesis Aneurysm, Dissecting Blood Models, Biological Aneurysm, Dissecting Surgery Adult Female Middle Age Male Tomography, X-Ray Computed Hemodynamics Blood Flow Velocity Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Aortic dissections are challenging for it remains perplexing to determine when surgical, endovascular, or medical therapies are optimal. We studied the effect of the multilayer flow modulator (MFM) device in patients with different forms of type-B aortic dissections. CT scans were performed pre-, immediately post-MFM implantation, and multiple times within a 24-month follow-up. Three-dimensional reconstructions were created from these scans and the multilayer or single-layer mesh device placed virtually into the true lumen. We observed that MFM device can sufficiently restore flow perfusion, reduce the false lumen, eliminate local flow recirculation, and reduce wall shear stress distribution globally. Single-layer devices can reduce false lumen dimensions; however, they generate local disturbance and recirculation zones in selected areas at specific time points. Moreover, in polar extremes of dissection, the MFM device restored flow to vital organs perfusing vessels independent of effects on luminal patency. Management of aortic dissections should focus on modulation of blood flow, suppression of local recirculation, and restoration of vital organ perfusion rather than primarily restoring vascular lumen morphology. While the latter restores the geometry of the true lumen, only the former restores homeostasis. Graphical abstract. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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