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Computational fluid dynamic analysis of the effect of morphologic features on distraction forces in fenestrated stent grafts  Steven M. Jones, MBChB,

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Presentation on theme: "Computational fluid dynamic analysis of the effect of morphologic features on distraction forces in fenestrated stent grafts  Steven M. Jones, MBChB,"— Presentation transcript:

1 Computational fluid dynamic analysis of the effect of morphologic features on distraction forces in fenestrated stent grafts  Steven M. Jones, MBChB, Robert J. Poole, PhD, Thien V. How, PhD, Rachel L. Williams, PhD, Richard G. McWilliams, FRCR, John A. Brennan, MD, FRCS, Srinivasa R. Vallabhaneni, MD, FRCS, Robert K. Fisher, MD, FRCS  Journal of Vascular Surgery  Volume 60, Issue 6, Pages e1 (December 2014) DOI: /j.jvs Copyright © 2014 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Analytical model for distraction force (DF) in a simplified bifurcated tube. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Regions of interest (ROIs) for fenestrated stent graft components. A, Proximal body (blue). Inlet: upper margin of proximal gold radiopaque fabric marker (PGM). Outlet: lower margin of distal gold radiopaque marker (DGM). The ROI is cropped perpendicular to stent rows (white arcs) in each case. Fenestrations are “cut” according to the position of the gold radiopaque markers. S, Scallop for superior mesenteric artery; F1, small fenestration for left renal artery. B, Distal body (green). Inlet: upper margin of proximal gold radiopaque marker (PGM) with ROI cropped perpendicular to first seal stent (white arc). Outlet: lower extent of the radiopaque “tick” marker (TM) perpendicular to the last stent of the contralateral gate and perpendicular to the distal seal stent of the ipsilateral limb (white arcs). C, Limb extension (orange). Inlet: perpendicular to the upper extent of the proximal seal stent (PS). Outlet: perpendicular to the lower extent of the distal seal stent (DS). The lumen is shown in red. The arrows indicate directions in which force results were obtained: x (red arrow), y (green arrow), z (blue arrow). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Angle measurement of one distal body in coronal and sagittal elevation. PB, Proximal extent of proximal body component; θl, left outlet angle (demonstrated in sagittal elevation only); θr, right outlet angle. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Correlation between inlet cross-sectional area (XSA) and total resultant distraction force (RDF). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

6 Fig 5 Comparison of total resultant distraction force (RDF) between outlet (θ) angle groups in stent graft components. The boxes represent median total RDF and interquartile range. Whiskers: 95% confidence interval; o, outlier at 95% confidence interval. *Outlier at 99% confidence interval. aIndicates significance to P < .01, Mann-Whitney U test. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

7 Fig 6 Plot of total resultant distraction force (RDF) normalized by the product of inlet pressure (Pres) and cross-sectional area (XSA). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

8 Fig 7 Total resultant distraction force (RDF) in (A) proximal body (blue), x force = 0.6N (not shown) and (B) limb extension (orange), x force = 0.2N (not shown). Images are shown in sagittal elevation. Note that in each case, total RDF acts in the direction in which migration occurs and is approximately orthogonal to the relevant seal zone. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

9 Supplementary Fig (online only)
Comparison between distraction force (DF) results obtained by three different methods at 0.1-second intervals along a pulse wave. CFD, Computational fluid dynamics. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

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