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Longitudinal computational fluid dynamics study of stenosis and aneurysmal degeneration of an aortorenal bypass.

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Title: Longitudinal computational fluid dynamics study of stenosis and aneurysmal degeneration of an aortorenal bypass.
Authors: Xiong, Zhuxiang1 (AUTHOR), Wang, Yi2 (AUTHOR), Mou, Zeyang1 (AUTHOR), Li, Yan1 (AUTHOR), Liu, Zhan1 (AUTHOR), Wen, Jun3 (AUTHOR), Yuan, Ding4,5 (AUTHOR) docyuanding@gmail.com, Zheng, Tinghui1,6 (AUTHOR) tinghuizh@scu.edu.cn
Source: Biomechanics & Modeling in Mechanobiology. Oct2020, Vol. 19 Issue 5, p1965-1975. 11p.
Subjects: Flow separation, Renal artery, Saphenous vein, Stagnation flow, Degeneration (Pathology), Hemodynamics
Abstract: Saphenous vein graft (SVG) bypass placement is regarded as the optimal option for renal artery stenosis, which usually causes secondary hypertension and poor renal perfusion. Using computational fluid dynamics, this study aimed to investigate the underlying hemodynamic mechanism of the vein aneurysm and stenosis after aortorenal bypass surgery. Three-dimensional models were reconstructed based on computed tomographic angiography images of a 20-year-old female patient who suffered from uncontrollable hypertension using the image processing package Mimics (Materialise). The morphology and hemodynamic parameters in the healthy state, at initial presentation and at post-operative 9-month and 2-year follow-ups after surgery were analysed. The hemodynamic parameters became normal in the left and right renal arteries after bypass surgery. However, flow separation and stagnation occurred at the post-operative 9-month aorta-vein anastomosis, which caused asymmetrical flow and extremely high wall shear stress (WSS) and WSS gradients at the outflow vein tract, where the stenosis occurred 2 years later. In addition, the graft bending produced an asymmetrical flow pattern downstream. This research revealed that the abnormal hemodynamics, including flow separation and extremely high WSS values and gradients, caused by the retrograde flow of aortorenal bypass may be responsible for the SVG degeneration. In addition, flow asymmetry due to vessel bending is a potential risk factor for SVG aneurysm dilation. [ABSTRACT FROM AUTHOR]
Copyright of Biomechanics & Modeling in Mechanobiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Longitudinal computational fluid dynamics study of stenosis and aneurysmal degeneration of an aortorenal bypass.
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  Data: <searchLink fieldCode="AR" term="%22Xiong%2C+Zhuxiang%22">Xiong, Zhuxiang</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Yi%22">Wang, Yi</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mou%2C+Zeyang%22">Mou, Zeyang</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Yan%22">Li, Yan</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Liu%2C+Zhan%22">Liu, Zhan</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wen%2C+Jun%22">Wen, Jun</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yuan%2C+Ding%22">Yuan, Ding</searchLink><relatesTo>4,5</relatesTo> (AUTHOR)<i> docyuanding@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Zheng%2C+Tinghui%22">Zheng, Tinghui</searchLink><relatesTo>1,6</relatesTo> (AUTHOR)<i> tinghuizh@scu.edu.cn</i>
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  Data: <searchLink fieldCode="JN" term="%22Biomechanics+%26+Modeling+in+Mechanobiology%22">Biomechanics & Modeling in Mechanobiology</searchLink>. Oct2020, Vol. 19 Issue 5, p1965-1975. 11p.
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  Data: <searchLink fieldCode="DE" term="%22Flow+separation%22">Flow separation</searchLink><br /><searchLink fieldCode="DE" term="%22Renal+artery%22">Renal artery</searchLink><br /><searchLink fieldCode="DE" term="%22Saphenous+vein%22">Saphenous vein</searchLink><br /><searchLink fieldCode="DE" term="%22Stagnation+flow%22">Stagnation flow</searchLink><br /><searchLink fieldCode="DE" term="%22Degeneration+%28Pathology%29%22">Degeneration (Pathology)</searchLink><br /><searchLink fieldCode="DE" term="%22Hemodynamics%22">Hemodynamics</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Saphenous vein graft (SVG) bypass placement is regarded as the optimal option for renal artery stenosis, which usually causes secondary hypertension and poor renal perfusion. Using computational fluid dynamics, this study aimed to investigate the underlying hemodynamic mechanism of the vein aneurysm and stenosis after aortorenal bypass surgery. Three-dimensional models were reconstructed based on computed tomographic angiography images of a 20-year-old female patient who suffered from uncontrollable hypertension using the image processing package Mimics (Materialise). The morphology and hemodynamic parameters in the healthy state, at initial presentation and at post-operative 9-month and 2-year follow-ups after surgery were analysed. The hemodynamic parameters became normal in the left and right renal arteries after bypass surgery. However, flow separation and stagnation occurred at the post-operative 9-month aorta-vein anastomosis, which caused asymmetrical flow and extremely high wall shear stress (WSS) and WSS gradients at the outflow vein tract, where the stenosis occurred 2 years later. In addition, the graft bending produced an asymmetrical flow pattern downstream. This research revealed that the abnormal hemodynamics, including flow separation and extremely high WSS values and gradients, caused by the retrograde flow of aortorenal bypass may be responsible for the SVG degeneration. In addition, flow asymmetry due to vessel bending is a potential risk factor for SVG aneurysm dilation. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Biomechanics & Modeling in Mechanobiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s10237-020-01320-9
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        Text: English
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        StartPage: 1965
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      – SubjectFull: Flow separation
        Type: general
      – SubjectFull: Renal artery
        Type: general
      – SubjectFull: Saphenous vein
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      – SubjectFull: Stagnation flow
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      – SubjectFull: Hemodynamics
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              M: 10
              Text: Oct2020
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