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ORIGINAL RESEARCH article

Front. Surg.
Sec. Vascular Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1399230
This article is part of the Research Topic Minimally Invasive Cardiothoracic Surgery: Cost-Effectiveness, Prognostic Factors, and Outcomes View all 5 articles

Hemodynamic changes for half cover Left subclavian artery ostium during thoracic endovascular aortic repair

Provisionally accepted
Wei Bi Wei Bi 1*Xiaowei Li Xiaowei Li 2Xiaoming Yuan Xiaoming Yuan 3Zan Wen Zan Wen 3Minghua An Minghua An 4
  • 1 Department of Vascular Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, China
  • 2 Department of Cardiovascular surgery, First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, China
  • 3 Yanshan University, Qinhuangdao, Hebei, China
  • 4 The QinHuangDao HaiGang Hospital, Qinhuangdao, Hebei Province, China

The final, formatted version of the article will be published soon.

    Purpose: Some clinicians use endografts to cover half the left subclavian artery (LSA) ostium to cure some cases with insufficient proximal landing zone (PLZ) in thoracic endovascular aortic repair (TEVAR) treatment. We used computational fluid dynamics (CFD) to study the hemodynamic changes in the LSA because they may cause acute thrombosis or arteriosclerosis.: The digital model of the aortic arch was established and named model A, which only included the supraarch branch of the LSA. By directly covering half of the LSA ostium, which was named as model B. All established models were imported into the Gambit grid division software for grid division and were subsequently imported into the Fluent software for hemodynamic numerical simulation and calculation to analyze the related changes in LSA hemodynamic parameters after stent implantation. Results: Under the same aortic inlet flow, in model B, the local blood flow velocity of the LSA ostium increased and the whole blood flow velocity at the distal end decreased. The average wall shear stress (WSS) of the LSA was significantly decreased. Meanwhile there was an obvious turbulent flow in the LSA lumen, and the related blood flow state was disordered.Aorta stent affect hemodynamics of branch artery covering half the LSA ostium can cause obvious hemodynamic changes, which is likely to cause a long-term arteriosclerosis or acute thrombosis of the LSA, finally increasing the risk of stroke. Once this operation is performed in some specific clinical cases for simplicity and economy, it seems that we should actively antiplatelet and follow up regularly.

    Keywords: Thoracic endovascular aortic repair, Endograft, half coverage, Left subclavian artery, computational fluid dynamics

    Received: 11 Mar 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Bi, Li, Yuan, Wen and An. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wei Bi, Department of Vascular Surgery, Second Hospital of Hebei Medical University, Shijiazhuang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.