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当主动脉夹层累及左侧锁骨下动脉时,有时需要植入两枚支架对主干和分支血管同时进行治疗。本研究应用Pro/engineer wildfire3.0建立人体主动脉弓及其分支模型并模拟支架植入,依据主干内支架杆突入左锁骨下动脉开口处情况不同建立3种模型,以未植入支架的正常主动脉弓为对照组,应用ANSYS11.0 CFX软件分别进行计算流体力学分析,比较支架杆突入左锁骨下动脉开口情况不同对分支血管血流速度及血管壁面剪切力影响的差异。结果发现:突入左侧锁骨下动脉开口的支架杆引起分支动脉中血流速度明显减慢及大范围低剪切力区形成,文献报道这种低速、低剪切力环境可能促使血栓形成和内膜增生,导致支架内再狭窄,故有必要使用专门的预成型分支型主动脉支架治疗累及左锁骨下动脉的主动脉夹层动脉瘤。
When the aortic dissection involves the left subclavian artery, sometimes two stents are implanted to treat the trunk and branch vessels simultaneously. In this study, the human aortic arch and its branch model were established by Pro / engineer wildfire3.0 and the stent implantation was simulated. According to the situation that the main stem rod broke into the left subclavian artery, three models were established. The normal aortic arch without stent implantation was In the control group, CFD software ANSYS11.0 was used to perform computational fluid dynamics analysis respectively. The differences of the effects of the stent bar penetrating into the left subclavian artery on the branch blood flow velocity and the vessel wall shear force were compared. The results showed that the stenting rod penetrating into the opening of the left subclavian artery caused a significant slowdown of blood flow velocity in the branch artery and the formation of a large area of low shear force. It has been reported in the literature that this low-velocity and low-shear environment may promote thrombosis and internal Membrane hyperplasia, resulting in stent restenosis, it is necessary to use a special pre-formed branch-type aortic stent involving the treatment of the left subclavian artery aortic dissecting aneurysms.