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RAHMANI SHAHROKH, EBRAHIMI BEHDADSHAARBAF, HEIDARI ALIREZA, NAVIDBAKHSH MAHDI, ALIZADEH MANSOUR, TAFTI HOSSEINAHMADI. HEMODYNAMIC INVESTIGATION OF SUBCLAVIAN-CORONARY STEAL SYNDROME IN DIALYSIS PATIENTS WITH CORONARY ARTERY OCCLUSION AND DIFFERENT STENOSIS PERCENTAGES IN SUBCLAVIAN ARTERY. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419500520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: Diseases of the coronary arteries represent critical cardiovascular bleakness and mortality around the world. The main focus of this study is to simulate hemodialysis patients undergoing Coronary Artery Bypass Graft (CABG) surgery by the left internal mammary artery. The survey is to investigate whether subclavian-coronary steal syndrome will occur in patients with stenosis in their left subclavian. Methods: A three-dimensional model of Brachial—Radial—Ulnar tree arterial system and dialysis graft are constructed and then simulated by the implementation of fluid–structure interaction (FSI) and non-FSI models. After consent was obtained, data attributed to dialysis patients who had undergone coronary bypass surgery at the Tehran Heart Center (THD) was collected. Results: Stenosis in the subclavian artery causes the left internal mammary artery (LIMA) graft to lack flow that, in CABG cases, is supplying the heart muscle. With the increase of stenosis from zero to 54%, the flow results show a negative flow indicating reversed flow in the artery. Meanwhile, the comparison between flow quantity of a normal Left Anterior Descending (LAD) and LIMA in case of 38% stenosis in subclavian shows that the amount of flow reaching the heart is less than standard. The threshold stenosis in the subclavian artery for which subclavian-coronary steal phenomena occurs is simulated to be around 54%. Furthermore, investigation of the effect of flow quantity in cases of hemodialysis versus nonhemodialysis shows that the flow is lessened in case of hemodialysis. Conclusions: In hemodialysis patients with more than 38% stenosis in left subclavian, it is well advised that LIMA bypass graft is not the preferred graft choice, and at 54% of subclavian stenosis, the steal phenomenon occurs.
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Affiliation(s)
- SHAHROKH RAHMANI
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
| | - BEHDAD SHAARBAF EBRAHIMI
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
- Bioengineering Faculty, University of Auckland, New Zealand
| | - ALIREZA HEIDARI
- Structural Engineering, School of Civil Engineering, Faculty of Engineering, University of Tehran, Iran
| | - MAHDI NAVIDBAKHSH
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
| | - MANSOUR ALIZADEH
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
| | - HOSSEIN AHMADI TAFTI
- Department of Cardiac Surgery, Tehran University of Medical Sciences, Tehran 14167, Iran
- Department of Cardiac Surgery, Tehran Heart Center, Tehran 14117, Iran
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Rafailidis V, Li X, Chryssogonidis I, Rengier F, Rajiah P, Wieker CM, Kalva S, Ganguli S, Partovi S. Multimodality Imaging and Endovascular Treatment Options of Subclavian Steal Syndrome. Can Assoc Radiol J 2018; 69:493-507. [DOI: 10.1016/j.carj.2018.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/20/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Vasileios Rafailidis
- AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Xin Li
- University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ioannis Chryssogonidis
- AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fabian Rengier
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Prabhakar Rajiah
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Carola M. Wieker
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Sanjeeva Kalva
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Suvranu Ganguli
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sasan Partovi
- Section of Interventional Radiology, Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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