{"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}
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.
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.