Assessing Differences in Aortic Haemodynamics Between Two vs. Four Vessel Fenestrated Endovascular Aortic Repair using Patient Specific Computational Flow Simulation

Fenestrated endovascular aortic repair (FEVAR) techniques require the protrusion of target vessel stent grafts into the aortic flow lumen, which has been associated with turbulent flow patterns in the adjacent aorta and may adversely affect downstream haemodynamics. 1 Tran K. Yang W. Marsden A. Lee J.T. Patient-specific computational flow modelling for assessing hemodynamic changes following fenestrated endovascular aneurysm repair. JVS Vasc Sci. 2021; 2: 53-69 Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar ,2 Kandail H. Hamady M. Xu X.Y. Effect of a flared renal stent on the performance of fenestrated stent-grafts at rest and exercise conditions. J Endovasc Ther. 2016; 23: 809-820 Crossref PubMed Scopus (11) Google Scholar Recent advances in computational flow simulation (CFS) have enabled quantification of physiological haemodynamics in cardiovascular pathologies, but have seldom been applied to study complex EVAR in a patient specific manner. 2 Kandail H. Hamady M. Xu X.Y. Effect of a flared renal stent on the performance of fenestrated stent-grafts at rest and exercise conditions. J Endovasc Ther. 2016; 23: 809-820 Crossref PubMed Scopus (11) Google Scholar ,3 Kandail H. Hamady M. Xu X.Y. Comparison of blood flow in branched and fenestrated stent-grafts for endovascular repair of abdominal aortic aneurysms. J Endovasc Ther. 2015; 22: 578-590 Crossref PubMed Scopus (32) Google Scholar The aim was to use patient specific CFS to investigate haemodynamic differences between patients treated with two vessel (2V) vs. four vessel (4V) FEVAR, with a focus on how additional graft fabric protrusion into the aortic lumen effects renovisceral perfusion and aortic laminar flow patterns.