经颈静脉肝内门静脉系统分流术(TIPS)手术策略的评估:计算流体动力学视角。

IF 2.7 3区 医学 Q2 BIOPHYSICS
Baopeng Wu, Hao Han, Jing Yao, Lingyu Jiang, Jian Yang, Ying Xin, Runxin Fang, Lingling Wei, Shicheng He, Zhiyong Li, Qiang Chen
{"title":"经颈静脉肝内门静脉系统分流术(TIPS)手术策略的评估:计算流体动力学视角。","authors":"Baopeng Wu, Hao Han, Jing Yao, Lingyu Jiang, Jian Yang, Ying Xin, Runxin Fang, Lingling Wei, Shicheng He, Zhiyong Li, Qiang Chen","doi":"10.1007/s10237-025-01970-7","DOIUrl":null,"url":null,"abstract":"<p><p>Transjugular intrahepatic portosystemic shunt (TIPS) surgery is commonly employed to treat the portal hypertension (PH), and an appropriate surgical strategy is crucial to balance the surgical outcome and post-TIPS complications. This study numerically explored the effects of six TIPS surgical strategies on the shunt outcome and PV stenosis risk by considering three stent insertion positions with two in-vessel covered lengths from the perspective of the hemodynamics. Sequential CT images of 21 PH subjects were used to reconstruct the six kinds of virtual TIPS surgical models with 6 mm stent and further to compare their five post-TIPS hemodynamic indexes. According to four of the five indexes, it was found that although there was no significant difference between the six surgical strategies, the stent insertion into the main portal vein (MPV) with in-vessel covered length 0 cm was slightly better to reduce the PV pressure, improve the shunt outcome, and potentially decrease the post-TIPS PV stenosis risk. The current findings could be helpful for clinical applications in the aspect of selecting TIPS surgical strategy to treat the PH.</p>","PeriodicalId":489,"journal":{"name":"Biomechanics and Modeling in Mechanobiology","volume":" ","pages":"1327-1341"},"PeriodicalIF":2.7000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of the transjugular intrahepatic portosystemic shunt (TIPS) surgical strategies: a computational fluid dynamics perspective.\",\"authors\":\"Baopeng Wu, Hao Han, Jing Yao, Lingyu Jiang, Jian Yang, Ying Xin, Runxin Fang, Lingling Wei, Shicheng He, Zhiyong Li, Qiang Chen\",\"doi\":\"10.1007/s10237-025-01970-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Transjugular intrahepatic portosystemic shunt (TIPS) surgery is commonly employed to treat the portal hypertension (PH), and an appropriate surgical strategy is crucial to balance the surgical outcome and post-TIPS complications. This study numerically explored the effects of six TIPS surgical strategies on the shunt outcome and PV stenosis risk by considering three stent insertion positions with two in-vessel covered lengths from the perspective of the hemodynamics. Sequential CT images of 21 PH subjects were used to reconstruct the six kinds of virtual TIPS surgical models with 6 mm stent and further to compare their five post-TIPS hemodynamic indexes. According to four of the five indexes, it was found that although there was no significant difference between the six surgical strategies, the stent insertion into the main portal vein (MPV) with in-vessel covered length 0 cm was slightly better to reduce the PV pressure, improve the shunt outcome, and potentially decrease the post-TIPS PV stenosis risk. The current findings could be helpful for clinical applications in the aspect of selecting TIPS surgical strategy to treat the PH.</p>\",\"PeriodicalId\":489,\"journal\":{\"name\":\"Biomechanics and Modeling in Mechanobiology\",\"volume\":\" \",\"pages\":\"1327-1341\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Biomechanics and Modeling in Mechanobiology\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1007/s10237-025-01970-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"BIOPHYSICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomechanics and Modeling in Mechanobiology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s10237-025-01970-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"BIOPHYSICS","Score":null,"Total":0}
引用次数: 0

摘要

经颈静脉肝内门静脉系统分流术(TIPS)是治疗门静脉高压症(PH)的常用方法,选择合适的手术策略对于平衡手术效果和TIPS术后并发症至关重要。本研究从血流动力学的角度,通过考虑三种支架置入位置和两种血管覆盖长度,数值探讨了六种TIPS手术策略对分流结局和PV狭窄风险的影响。利用21例PH受试者的连续CT图像重建6种虚拟TIPS手术模型,并比较其TIPS后的5项血流动力学指标。根据5项指标中的4项,我们发现虽然6种手术策略之间没有显著差异,但门静脉主静脉(MPV)内支架置入术在降低门静脉压力、改善分流效果、降低tips术后门静脉狭窄风险方面稍好,且门静脉主干覆盖长度为0 cm。本研究结果可为临床选择TIPS手术策略治疗PH提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of the transjugular intrahepatic portosystemic shunt (TIPS) surgical strategies: a computational fluid dynamics perspective.

Transjugular intrahepatic portosystemic shunt (TIPS) surgery is commonly employed to treat the portal hypertension (PH), and an appropriate surgical strategy is crucial to balance the surgical outcome and post-TIPS complications. This study numerically explored the effects of six TIPS surgical strategies on the shunt outcome and PV stenosis risk by considering three stent insertion positions with two in-vessel covered lengths from the perspective of the hemodynamics. Sequential CT images of 21 PH subjects were used to reconstruct the six kinds of virtual TIPS surgical models with 6 mm stent and further to compare their five post-TIPS hemodynamic indexes. According to four of the five indexes, it was found that although there was no significant difference between the six surgical strategies, the stent insertion into the main portal vein (MPV) with in-vessel covered length 0 cm was slightly better to reduce the PV pressure, improve the shunt outcome, and potentially decrease the post-TIPS PV stenosis risk. The current findings could be helpful for clinical applications in the aspect of selecting TIPS surgical strategy to treat the PH.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Biomechanics and Modeling in Mechanobiology
Biomechanics and Modeling in Mechanobiology 工程技术-工程:生物医学
CiteScore
7.10
自引率
8.60%
发文量
119
审稿时长
6 months
期刊介绍: Mechanics regulates biological processes at the molecular, cellular, tissue, organ, and organism levels. A goal of this journal is to promote basic and applied research that integrates the expanding knowledge-bases in the allied fields of biomechanics and mechanobiology. Approaches may be experimental, theoretical, or computational; they may address phenomena at the nano, micro, or macrolevels. Of particular interest are investigations that (1) quantify the mechanical environment in which cells and matrix function in health, disease, or injury, (2) identify and quantify mechanosensitive responses and their mechanisms, (3) detail inter-relations between mechanics and biological processes such as growth, remodeling, adaptation, and repair, and (4) report discoveries that advance therapeutic and diagnostic procedures. Especially encouraged are analytical and computational models based on solid mechanics, fluid mechanics, or thermomechanics, and their interactions; also encouraged are reports of new experimental methods that expand measurement capabilities and new mathematical methods that facilitate analysis.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信