Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair

We examined the possible reasons for common carotid artery chimney stent graft occlusion through computational fluid dynamics analyses of follow-up imaging of a patient-specific aortic configuration reconstructed from computed tomography aortography. Anatomic and hemodynamic parameters were extracte...

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Main Authors:	Rosamaria Tricarico, PhD, Yong He, PhD, Roger Tran-Son-Tay, PhD, Liza Laquian, MD, Adam W. Beck, MD, Scott A. Berceli, MD, PhD
Format:	Article
Language:	English
Published:	Elsevier 2019-06-01
Series:	Journal of Vascular Surgery Cases and Innovative Techniques
Online Access:	http://www.sciencedirect.com/science/article/pii/S2468428719300280

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spelling	doaj-4b7024f613ac4003ba1866b55875cf402020-11-24T21:16:08ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872019-06-0152187194Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repairRosamaria Tricarico, PhD0Yong He, PhD1Roger Tran-Son-Tay, PhD2Liza Laquian, MD3Adam W. Beck, MD4Scott A. Berceli, MD, PhD5Department of Biomedical Engineering, University of Florida, Gainesville, FlaNorth Florida/South Georgia Veterans Health System, Gainesville, Fla; Department of Surgery, University of Florida, Gainesville, FlaDepartment of Biomedical Engineering, University of Florida, Gainesville, Fla; Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FlaDepartment of Surgery, University of Florida, Gainesville, FlaDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham, Birmingham, AlaDepartment of Biomedical Engineering, University of Florida, Gainesville, Fla; North Florida/South Georgia Veterans Health System, Gainesville, Fla; Department of Surgery, University of Florida, Gainesville, Fla; Correspondence: Scott A. Berceli, MD, PhD, Professor of Surgery, Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, PO Box 100128, 1600 SW Archer Rd, Gainesville, FL 32610-0286We examined the possible reasons for common carotid artery chimney stent graft occlusion through computational fluid dynamics analyses of follow-up imaging of a patient-specific aortic configuration reconstructed from computed tomography aortography. Anatomic and hemodynamic parameters were extracted for the bilateral common carotid and subclavian arteries before and after endograft placement. Results suggested that postoperative reduction in lumen diameter within the chimney stent graft combined with an increased flow rate led to complex hemodynamics with high wall shear stress, probably resulting in high-shear thrombogenesis and chimney stent graft occlusion 2.6 years after the primary repair. Early postoperative duplex ultrasound imaging might help identify at-risk conditions. Keywords: Chimney stent graft, Common carotid artery, Postoperative stent graft occlusion, TEVAR, Hybrid thoracic aortic aneurysm repairhttp://www.sciencedirect.com/science/article/pii/S2468428719300280
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Rosamaria Tricarico, PhD Yong He, PhD Roger Tran-Son-Tay, PhD Liza Laquian, MD Adam W. Beck, MD Scott A. Berceli, MD, PhD
spellingShingle	Rosamaria Tricarico, PhD Yong He, PhD Roger Tran-Son-Tay, PhD Liza Laquian, MD Adam W. Beck, MD Scott A. Berceli, MD, PhD Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair Journal of Vascular Surgery Cases and Innovative Techniques
author_facet	Rosamaria Tricarico, PhD Yong He, PhD Roger Tran-Son-Tay, PhD Liza Laquian, MD Adam W. Beck, MD Scott A. Berceli, MD, PhD
author_sort	Rosamaria Tricarico, PhD
title	Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair
title_short	Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair
title_full	Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair
title_fullStr	Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair
title_full_unstemmed	Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair
title_sort	anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair
publisher	Elsevier
series	Journal of Vascular Surgery Cases and Innovative Techniques
issn	2468-4287
publishDate	2019-06-01
description	We examined the possible reasons for common carotid artery chimney stent graft occlusion through computational fluid dynamics analyses of follow-up imaging of a patient-specific aortic configuration reconstructed from computed tomography aortography. Anatomic and hemodynamic parameters were extracted for the bilateral common carotid and subclavian arteries before and after endograft placement. Results suggested that postoperative reduction in lumen diameter within the chimney stent graft combined with an increased flow rate led to complex hemodynamics with high wall shear stress, probably resulting in high-shear thrombogenesis and chimney stent graft occlusion 2.6 years after the primary repair. Early postoperative duplex ultrasound imaging might help identify at-risk conditions. Keywords: Chimney stent graft, Common carotid artery, Postoperative stent graft occlusion, TEVAR, Hybrid thoracic aortic aneurysm repair
url	http://www.sciencedirect.com/science/article/pii/S2468428719300280
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Anatomic and hemodynamic investigation of an occluded common carotid chimney stent graft for hybrid thoracic aortic aneurysm repair

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