AUTHOR=Zhu Yating , Li Fen , Zhang Hongpeng , Song Hui , Ma Xiaodan , Cao Long , Zhang Wenjun , Guo Wei 

TITLE=Hemodynamic numerical simulation of aortic arch modular inner branched stent-graft in eight early patients from the first-in-human case series

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.981546

DOI=10.3389/fcvm.2022.981546

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>The modular inner branched stent-graft (MIBSG) (WeFlow-Arch™) is an emerging device for challenging aortic arch pathologies. Hemodynamic numerical simulation is conducive to predicting long-term outcomes as well as optimizing the stent-graft design.</p></sec><sec><title>Objective</title><p>This study aims to analyze the hemodynamic characteristics of the MIBSG devices based on numerical simulation analyses.</p></sec><sec><title>Methods</title><p>From June 2019 to June 2021, MIBSGs were utilized in eight cases. Numerical simulation analyses of branch perfusion and indicators including the time-averaged wall shear stress, oscillatory shear index, and relative residence time were performed.</p></sec><sec><title>Results</title><p>Lesions involved Zone 1 (<italic>n</italic> = 2), Zone 2 (<italic>n</italic> = 4), and Zone 3 (<italic>n</italic> = 2). Branched stent-grafts were deployed in the innominate artery and left common carotid artery (<italic>n</italic> = 5) or in the innominate artery and left subclavian artery (<italic>n</italic> = 3). The hemodynamic change in common was increased perfusion in the descending aorta and left common carotid artery. Half of the patients had increased cerebral perfusion of 8.7% at most, and the other half of the patients showed a reduction of 5.3% or less. Case 3 was considered to have acquired the greatest improvement in hemodynamic features.</p></sec><sec><title>Conclusion</title><p>The MIBSG showed improved hemodynamic features in most cases. The design of the MIBSG could be partly modified to acquire better hemodynamic performance.</p></sec>