支架介入治疗颈内动脉狭窄和动脉瘤对动脉瘤壁面压力的影响  

Effect on aneurysmal pressure after stent intervention treatment for aneurysm accompanied by stenosis

作　　者：付文宇[1,2] 殷文聪[3] 乔爱科[3] 

机构地区：[1]北京联合大学机械与电子工程学院,北京100020 [2]北京工业大学建筑与工程学院,北京100124 [3]北京工业大学生命科学与生物工程学院,北京100124

出　　处：《医用生物力学》2012年第5期501-504,514,共5页Journal of Medical Biomechanics

基　　金：国家自然科学基金资助项目(10972016;81171107);北京市自然科学基金资助项目(3092004)

摘　　要：目的研究当狭窄与动脉瘤毗邻时,使用支架介入治疗后对动脉瘤壁面压力产生的影响。方法使用计算流体动力学分析的方法对动脉瘤模型及狭窄和动脉瘤毗邻的模型进行对比研究。构建3个模型(M1、M2、M3)对压力变化进行分析比较。M1是颈内动脉瘤模型(无狭窄、无支架),在M1中的动脉瘤前构造一段狭窄动脉形成M2,在M2的动脉瘤部位植入支架后形成M3。结果 M2、M1两个模型相比较,轻度狭窄(50%)引起的动脉瘤部位的压力增加约为1.369 9 kPa(10.3 mmHg)(收缩期的峰值时刻),一个心动周期内动脉瘤部位的平均压力增加约为0.572 kPa(4.3 mmHg)。M3、M2两个模型相比较,动脉瘤部位的压力增加大约为1.037 kPa(7.8 mmHg)(收缩期的峰值时刻),一个心动周期内动脉瘤部位的平均压力增加大约为0.399 kPa(3 mmHg)。结论当使用支架治疗狭窄与弯曲颅内动脉瘤毗邻的患者时,轻度狭窄不会导致显著压力增加。载瘤动脉的形状、动脉瘤或动脉狭窄疾病确实对动脉瘤部位压力变化有影响。Objective To investigate the effect on aneurysmal pressure after stent intervention treatment for aneurysm accompanied by stenosis.Methods Computational fluid dynamics（CFD） analyses were carried out to make comparative study on aneurysm models with and without stenosis.Three models（M1,M2,M3） were constructed to compare the pressure variations.M1 was the aneurysm model with no stenosis and no stent,M2 was forming from M1 model with a preaneurysm stenosis,and M3 was the M2 model with stent implantation at the place of the aneurysm.Results For comparison between M2 and M1,pressure increase in the aneurismal sac caused by a mild stenosis（50%） was about 1.399 9 kPa（10.3 mmHg） with the peak systole,and the average pressure increase in a cardiac cycle was about 0.572 kPa（4.3 mmHg）.For comparison between M2 and M3,pressure increase in the aneurismal sac was about 1.037 kPa（7.8 mmHg） at peak systole in a cardiac cycle,and the average pressure increase in the aneurismal sac in a cardiac cycle was about 0.399 kPa（3 mmHg）.Conclusions A mild stenosis could not result in the sharp pressure increase with stent intervention applied to the treatment of aneurysm accompanied by stenosis harbored on a tortuous intracranial artery.The geometry of the parent vessel and its aneurysmal/stenotic diseases do have influence on the pressure variation at the place of aneurysm.

关 键 词：动脉瘤 狭窄 支架 压力 计算流体动力学 

分 类 号：R318.01[医药卫生—生物医学工程]