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1Kentucky Pediatric and Adult Research, Bardstown, KY; 2Ohio Pediatric Research Association, Dayton, OH; 3Resolve Research Solutions, Ontario, Canada; ...
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The main purpose of the PEDAL study is to identify and estimate sample individual pharmacokinetic- pharmacodynamic (PK-PD) models for duodenal infusion ...
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May-Thurner syndrome (MTS) is a rare clinical condition involving stenosis of the left common iliac vein (CIV) due to its compression between the overriding right ...
EFFECT OF VENOUS STENOSIS ON FLOW RESISTANCE: A FLUID DYNAMIC MODEL E. IMENI
a POUR ,
F.
a MOUZAKIS ,
A.
a KASHEFI ,
M.
b BARBATI ,
H.
b JALAIE ,
K.
a MOTTAGHY
BACKGROUND
RESULTS
May-Thurner syndrome (MTS) is a rare clinical condition involving stenosis of the left common iliac vein (CIV) due to its compression between the overriding right common iliac artery and the underlying vertebral body. Over the time, the sustained compression and trauma caused by the pulsation of the artery provokes the formation of webs and spurs. This can lead to obstruction of the blood flow in the vein, which can result in stasis and thrombus formation. The clinical presentation and history of the patient are critical components in formulating a diagnosis of MTS.
Experimental data demonstrate an increased pressure drop already by a 10% degree of stenosis, whereas flow is also gradually affected when luminal narrowing exceeds 30%. Furthermore, the results exhibit the precision of the pressure measuring method (hence in mmH2O) even at low venous flow rates, which subsequently facilitates the establishment of the pressure-flow relationship as a function of luminal narrowing. 30
There are currently no standardized clinical or radiologic diagnostic protocols in place to aid in the identification of MTS. In this study we attempt to identify a quantitative degree of stenosis, by investigating the impact of various luminal narrowing degrees on pressure drop across the stenosis and on blood flow rate.
Fig. 3. Pressure Drop caused by various working media (A: H2O, B: Glycerol, C: Porcine Blood – Hct. 40%) for several grades of stenosis. Fig. 2. Position of occurring stenosis and subsequent stent application.
METHODS & MATERIALS A hydraulic circulation model simulating venous flow with several degrees of luminal narrowing has been developed by inserting defined stenosis cross sections. The system has been systematically investigated with water, as well as with other working mediums of various viscosities, including animal blood. a Extracorporeal
Circulation Laboratory, Institute of Physiology, University Hospital RWTH Aachen University, Germany
www.ecclab.de
CONCLUSION The findings of this study so far are very promising and it is further intended to implement several additional parameters in the circulation model, such as diverse stenosis effective lengths and volumes, which will further augment the model’s capability to discern the degree of stenosis, consequently rendering it a valuable experimental tool for clinical intervention techniques. b
Clinic for Vascular Surgery, University Hospital RWTH Aachen University, Germany
