Hemodynamic investigations on the portal hypertension and treatment of transjugular intrahepatic portosystemic shunt (TIPS) based on CFD simulation

Hemodynamic processes from the portal vein(PV) to the inferior vena cava(IVC) were mimicked for three patients with portal hypertension(PH) and the effects of stent parameters on the outcomes of transjugular intrahepatic portosystemic shunt(TIPS) were investigated through computational fluid dynamics(CFD). The liver region was simulated with porous media model and the spatial distributions of superior mesenteric vein(SMV) and splenic vein(SV) blood were solved through the Eulerian multiphase model. The present method is able to simulate the PH flow and predict the PV pressure, the stent shunt rate and the SMV blood proportion after TIPS treatment. According to the CFD results, the stent diameter exerts dominant effects on the TIPS outcomes while the stent placement shows substantial effects on the TIPS outcomes. Energy loss of the TIPS stents and distributary effects of the PV bifurcation dominate the PV hemodynamics and the TIPS outcomes. For stents with large diameter or proper placement, the energy loss is low therefore the PV pressure reduction and stent shunt rate are high. Stents inserted on the left and right branches of the PV are able to utilize distributary effects of the PV bifurcation therefore reduce the SMV blood flowing into the IVC.