Is Multiple Overlapping Uncovered Stents Technique Suitable for Aortic Aneurysm Repair?

Yeow, Siang Lin; Leo, Hwa Liang

doi:10.1111/aor.12993

Cited by 9 publications

(13 citation statements)

References 33 publications

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“…Our analysis of CDF results demonstrated that the TWASS on the sac wall declined with stent layers, which is strongly relevant in decreasing the velocity 25,30 . On the contrary, the aneurysmal OSI and RRT became greater after stenting, and the denser the MSs were, the greater were the OSI and RRT.…”

Section: Discussionmentioning

confidence: 68%

“…The region of low TAWSS, high OSI, and high RRT occurs at the centers of the eddies, because the closer the position is to the rotating center point, the slower the velocity will be. The combination of the low TAWSS, high OSI, and high RRT is an enabling environment for thrombus growth 19,25 , especially for high RRT, which would promote platelet aggregation to thrombose on the aneurysmal wall 19 . According to the analysis, we predicted that the thrombus would grow near the region of the center sac wall first, and the four-layer stent with a density of 52.4% has the best isolation when compared with other cases, which supports the view that the optimal regulation of the hemodynamic environment can be achieved by MSs with a porosity of 50–70% 25,31 .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the value of OSI ranges from 0 to 0.5, where 0 indicates WSS without oscillation, and 0.5 indicates WSS with an instantaneous frequent deviation 25 .…”

Section: Methodsmentioning

confidence: 99%

“…RRT represents the residence time of blood near the arterial wall and is a function of TAWSS and OSI, expressed as 25 …”

Section: Methodsmentioning

confidence: 99%

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Hemodynamic Performance of Multilayer Stents in the Treatment of Aneurysms with a Branch Attached

Hu²,

Chen

et al. 2019

Sci Rep

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Although multilayer stents (MSs) can be used to treat aneurysm effectively, for some aneurysms with branches attached, the hemodynamic mechanisms are still unclear. In this work, we modeled five cases that involve 1–4-layer stents implanted in aneurysms with side branches, and the numerical approach was used. Case 1 corresponds to an aneurysm without a stent, and cases 2–5 represent 1–4-layer stents being employed within aneurysms, respectively. The results showed that the velocity within the sac declined dramatically and the eddies’ intensity weakened with increased number of stent layers, time-averaged wall shear stress (TAWSS), and nitric oxide production rate (TAR NO ) dropped linearly with increase in stent porosity, and oscillatory shear index (OSI) and relative residence time (RRT) increased evidently with MS intervention. Moreover, the MSs had a slight effect on the patency of the side branch; its flow rate was still above the normal case than without aneurysm. It can be concluded that MSs are helpful in promoting the growth of thrombus within the aneurysm through an isolated hemodynamic environment and keeping the branch unobstructed, but more clinical evidences are required.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Hemodynamic Performance of Multilayer Stents in the Treatment of Aneurysms with a Branch Attached

Hu²,

Chen

et al. 2019

Sci Rep

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“…Siang Lin Yeow and Hwa Liang Leo of the Singapore General Hospital, Singapore, Singapore, reported on a computational fluid dynamic model to assess the impact of a flow‐diverter device on intra‐aneurysmal flow in complex aortic aneurysm. Flow diversion creates a natural hemodynamic environment to promote aneurysm thrombosis, thus stabilizing the aneurysm.…”

Section: Valves and Vascular Supportmentioning

confidence: 99%

Artificial Organs 2018: A Year in Review

Malchesky¹

2019

Artificial Organs

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In this Editor's Review, articles published in 2018 are organized by category and summarized. We provide a brief reflection of the research and progress in artificial organs intended to advance and better human life while providing insight for continued application of these technologies and methods. Artificial Organs continues in the original mission of its founders “to foster communications in the field of artificial organs on an international level.” Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. Peer‐reviewed special issues this year included contributions from the 13th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion edited by Dr. Akif Undar, and the 25th Congress of the International Society for Mechanical Circulatory Support edited by Dr. Marvin Slepian. Additionally, many editorials highlighted the worldwide survival differences in hemodialysis and perspectives on mechanical circulatory support and stem cell therapies for cardiac support. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide meaningful suggestions to the author's work whether eventually accepted or rejected. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, John Wiley & Sons for their expert attention and support in the production and marketing of Artificial Organs. We look forward to reporting further advances in the coming years.

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A systematic review and meta‐analysis of the performance of flow‐diverting stents in the treatment of peripheral and visceral artery aneurysms

Zhang

Xiang

et al. 2020

Cathet Cardio Intervent

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Objective This meta‐analysis aims to evaluate the safety and efficacy of flow‐diverting stents (FDS) in treating peripheral and visceral artery aneurysms (PAA/VAAs). Background Though rare, PAA/VAAs can represent a life‐threatening condition due to their propensity of rupture. The FDS emerges as a new solution to exclude these aneurysms while maintaining collateral branches, but convincing evidence is lacking on its clinical effectiveness. Methods A systematic literature search was performed to identify studies related to FDS in treating PAA/VAAs. The preferred reporting items for systematic reviews and meta‐analyses (PRISMA) statement was applied to guide the data extraction, quality assessment, and synthesis of outcomes of interest. Random effect models were applied to calculate the event rates of major endpoints. OpenMeta[Analyst] software was used for statistical analysis. Results Of 130 records screened, 10 cohort studies (including 220 patients, average age: 66.0 years, 78.4% male) were enrolled in the meta‐analysis. Pooled data suggested a technical success rate of 98.5% (95% CI: 97.0–100%). During a mean follow‐up period of 14.1 months, 93.6% (95% CI: 88.6–98.5%) side branches remained patent, 89.8% (95% CI: 84.3–95.3%) aneurysms were totally thrombosed, whereas shrinkage/stabilization of the aneurysm was documented in 93.4% (95% CI: 88.4–98.4%) cases. The primary stent patency rate was estimated to be 87.9% (95% CI: 81.0–94.8%). Overall clinical success was achieved in 83.2% (95% CI: 74.4–92.0%) patients. Conclusions The FDS features a potential advantage of preserving side branches while inducing sac thrombosis and aneurysm shrinkage/stabilization. Further prospective, comparative studies in larger patient cohorts are anticipated to draw a robust conclusion.

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Is Multiple Overlapping Uncovered Stents Technique Suitable for Aortic Aneurysm Repair?

Cited by 9 publications

References 33 publications

Hemodynamic Performance of Multilayer Stents in the Treatment of Aneurysms with a Branch Attached

Hemodynamic Performance of Multilayer Stents in the Treatment of Aneurysms with a Branch Attached

Artificial Organs 2018: A Year in Review

A systematic review and meta‐analysis of the performance of flow‐diverting stents in the treatment of peripheral and visceral artery aneurysms

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