Hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientations

Endovascular aortic repair (EVAR) has been increasingly used to treat abdominal aortic aneurysm (AAA) due to its lower mortality and shorter recovery time. However, the complications caused by renal artery coverage remained a major concern. In this study, three types of renal orientation and five ty...

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Main Authors: Jun Wen, Xinhui Liu, Jianguo Lei, Jiarong Wang, Xiyang Chen, Tinghui Zheng, Ding Yuan
Format: Article
Language:English
Published: Elsevier 2023-06-01
Series:Medicine in Novel Technology and Devices
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S259009352300019X
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author Jun Wen
Xinhui Liu
Jianguo Lei
Jiarong Wang
Xiyang Chen
Tinghui Zheng
Ding Yuan
author_facet Jun Wen
Xinhui Liu
Jianguo Lei
Jiarong Wang
Xiyang Chen
Tinghui Zheng
Ding Yuan
author_sort Jun Wen
collection DOAJ
description Endovascular aortic repair (EVAR) has been increasingly used to treat abdominal aortic aneurysm (AAA) due to its lower mortality and shorter recovery time. However, the complications caused by renal artery coverage remained a major concern. In this study, three types of renal orientation and five types of partial renal coverage degree were adopted to numerically investigate the flow pattern, wall shear stress distribution, and blood perfusion during a cardiac cycle. The results show that as for the mild partial coverage (=<30%), the renal artery with a downward orientation suffered fewer unfavorable wall shear stress (WSS) distribution and more blood perfusion. It should be noted that the renal artery with horizontal orientation suffered more unfavorable WSS distribution. In terms of severe coverage (≥50%), all of the renal arteries displayed highly disturbed wall shear distribution, resulting in a significant reduction in blood perfusion It was interesting to note that the artery with an upward orientation had a smaller rate of reduction in blood perfusion. It can be concluded that as for the mild renal coverage after EVAR, renal arteries with downward orientation may have the advantage of reducing the possibility of renal occlusion, while renal arteries with horizontal orientation may increase the unfavorable wall shear distribution. On the other hand, as for serious coverage (≥50%), high risk of renal ischemia remains the main concern for all types of renal arteries due to highly disturbed wall shear distribution would significantly increase regardless of renal orientation.
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spelling doaj.art-36c7ac8efa304fbcb47027955fdcd1472023-07-01T04:35:34ZengElsevierMedicine in Novel Technology and Devices2590-09352023-06-0118100224Hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientationsJun Wen0Xinhui Liu1Jianguo Lei2Jiarong Wang3Xiyang Chen4Tinghui Zheng5Ding Yuan6School of Computer Science and Technology, Southwest University of Science and Technology, Mianyang, 621010, ChinaInstitute of Civil Engineering and Architecture, Southwest University of Science and Technology, Mianyang, 621010, ChinaInstitute of Civil Engineering and Architecture, Southwest University of Science and Technology, Mianyang, 621010, ChinaDepartment of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, ChinaDepartment of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, ChinaDepartment of Applied Mechanics, Sichuan University, Chengdu, 610000, China; Corresponding author. Department of Applied Mechanics, Sichuan University, No. 24 S Section 1, Chengdu, 610065, China.Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China; Corresponding author. Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, 610065, China.Endovascular aortic repair (EVAR) has been increasingly used to treat abdominal aortic aneurysm (AAA) due to its lower mortality and shorter recovery time. However, the complications caused by renal artery coverage remained a major concern. In this study, three types of renal orientation and five types of partial renal coverage degree were adopted to numerically investigate the flow pattern, wall shear stress distribution, and blood perfusion during a cardiac cycle. The results show that as for the mild partial coverage (=<30%), the renal artery with a downward orientation suffered fewer unfavorable wall shear stress (WSS) distribution and more blood perfusion. It should be noted that the renal artery with horizontal orientation suffered more unfavorable WSS distribution. In terms of severe coverage (≥50%), all of the renal arteries displayed highly disturbed wall shear distribution, resulting in a significant reduction in blood perfusion It was interesting to note that the artery with an upward orientation had a smaller rate of reduction in blood perfusion. It can be concluded that as for the mild renal coverage after EVAR, renal arteries with downward orientation may have the advantage of reducing the possibility of renal occlusion, while renal arteries with horizontal orientation may increase the unfavorable wall shear distribution. On the other hand, as for serious coverage (≥50%), high risk of renal ischemia remains the main concern for all types of renal arteries due to highly disturbed wall shear distribution would significantly increase regardless of renal orientation.http://www.sciencedirect.com/science/article/pii/S259009352300019XHemodynamicsOrientationFollow-upNumerical simulationRenal artery
spellingShingle Jun Wen
Xinhui Liu
Jianguo Lei
Jiarong Wang
Xiyang Chen
Tinghui Zheng
Ding Yuan
Hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientations
Medicine in Novel Technology and Devices
Hemodynamics
Orientation
Follow-up
Numerical simulation
Renal artery
title Hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientations
title_full Hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientations
title_fullStr Hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientations
title_full_unstemmed Hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientations
title_short Hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientations
title_sort hemodynamics in renal arteries with partial coverage after endovascular aneurysm repair affected by renal orientations
topic Hemodynamics
Orientation
Follow-up
Numerical simulation
Renal artery
url http://www.sciencedirect.com/science/article/pii/S259009352300019X
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AT jiarongwang hemodynamicsinrenalarterieswithpartialcoverageafterendovascularaneurysmrepairaffectedbyrenalorientations
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