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Hemodynamic Implications of STABILISE Technique for Aortic Dissection Repair
Department of Vascular and Endovascular Surgery, Fiona Stanley Hospital, Perth, Australia; Curtin University, School of Medicine, Perth, Australia.
Department of Vascular and Endovascular Surgery, Fiona Stanley Hospital, Perth, Australia; Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and the UWA Centre for Medical Research, The University of Western Australia, Perth, Australia.
Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and the UWA Centre for Medical Research, The University of Western Australia, Perth, Australia; School of Engineering, The University of Western Australia, Perth, Australia.
KTH, School of Engineering Sciences (SCI), Engineering Mechanics, Fluid Mechanics. Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and the UWA Centre for Medical Research, The University of Western Australia, Perth, Australia; School of Engineering, The University of Western Australia, Perth, Australia.ORCID iD: 0000-0002-5409-8280
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2024 (English)In: Annals of Vascular Surgery, ISSN 0890-5096, E-ISSN 1615-5947, Vol. 98, p. 155-163Article in journal (Refereed) Published
Abstract [en]

Background: The stent-assisted balloon-induced intimal disruption and relamination (STABILISE) technique for treatment of type B dissection has shown promising clinical results at mid-term. Computational modeling is a way of noninvasively obtaining hemodynamic effects, such as pressure and wall shear stress, leading to a better understanding of potential benefits. Particular areas of interest are (1) the effect of intimal disruption and re-lamination and (2) the effect of the bare metal stent in the visceral aortic segment. Methods: Single-center prospective case series. Data from 5 consecutive locally performed cases of STABILISE technique were analyzed. Included cases were type B aortic dissection with or without prior de-branching. The STABILISE procedure had to be performed without 30-day major complications. Preoperative and postoperative imaging data for each patient were transferred to the biomedical engineering team. Each case was reconstructed, meshed, and simulated with computational fluid dynamics using patient-specific data (heart rate, blood pressure, height, and weight). Hemodynamic parameters were then extracted from the simulations. Results: In all cases, computational analysis showed for postoperative patients: (1) a drop in pressure difference between lumina and (2) lower wall shear stress effects, compared to their preoperative status. These observations were most pronounced in the visceral aortic segment. Conclusions: Computational modeling shows favourable changes in the flow dynamics of type B dissection treated using the STABILISE technique. This may suggest protective effects of this technique for long-term aortic healing and cicatrization.

Place, publisher, year, edition, pages
Elsevier BV , 2024. Vol. 98, p. 155-163
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Surgery Cardiology and Cardiovascular Disease
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URN: urn:nbn:se:kth:diva-367462DOI: 10.1016/j.avsg.2023.07.108ISI: 001135574600001PubMedID: 37805169Scopus ID: 2-s2.0-85176306212OAI: oai:DiVA.org:kth-367462DiVA, id: diva2:1984858
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QC 20250718

Available from: 2025-07-18 Created: 2025-07-18 Last updated: 2025-07-18Bibliographically approved

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Parker, Louis P.

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