О компьютерном моделировании кровотока в артериях ног

Борис Сергеевич Артюшин; Константин Николаевич Мовчан; Елена Александровна Лебедева; Максим Александрович Бондаренко; Ксения Игоревна Русакевич; Ренат Борисович Исхак

doi:10.21638/11701/spbu11.2018.103

Authors

Борис Сергеевич Артюшин Federal North-West medical research centre named after V. A. Almazov, 2, Akkuratova ul., St. Petersburg, 197341, Russian Federation; Saint Petersburg Medical informational and analytical centre, 30, Shkapina ul., St. Petersburg, 198095, Russian Federation
Константин Николаевич Мовчан North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation; Saint Petersburg Medical informational and analytical centre, 30, Shkapina ul., St. Petersburg, 198095, Russian Federation
Елена Александровна Лебедева Saint Petersburg Electrotechnical University “LETI”, 5, ul. Professora Popova, 197376, Russian Federation
Максим Александрович Бондаренко Saint Petersburg Electrotechnical University “LETI”, 5, ul. Professora Popova, 197376, Russian Federation
Ксения Игоревна Русакевич North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation
Ренат Борисович Исхак North-Western State Medical University named after I. I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, 191015, Russian Federation

DOI:

https://doi.org/10.21638/11701/spbu11.2018.103

Abstract

Used in medical practice, schemes of assessment of the arterial bed and prediction of treatment outcomes is ambiguous in its objectivity. Development of new methods for assessment of the arterial bed, of predicting the course of atherosclerosis of the arteries of the lower extremities, to select the optimal method of revascularisation of the arterial bed of the legs is a topical task of science and practice. On the basis of parameters obtained from the analysis of data, an instrumental examination of 10 employees (computer tomography, ultrasonic research of vessels of lower extremities) created a mathematical model of blood flow in the arteries of the legs at different localizations of their occlusive-stenotic lesions. The degree of stenotic changes are standardized: 20 %, 50 % and 75 %, occlusion of the artery. Changes in blood flow that occur with isolated and combined lesions of the arteries were estimated. It was demonstrated that the speed of blood flow in the stenosis of arteries of legs is increased; narrowing of the arteries lower leg > 65 % significantly reduces blood flow, and stenosis of vessels >75 % blood flow practically ceases; when combined occlusive-stenotic lesions of several arteries significant disruption of blood flow is observed with stenosis > 50 %. Occlusive-stenotic lesions not only affects the blood flow in the arteries, but also affects the hemodynamics in other vessels of the lower extremities. Modeling disorders of blood vessels in the feet can be an effective technology for the examination and treatment of patients with failure of blood supply of the lower extremities.

Keywords:

occlusive-stenotic lesions of blood vessels, computer simulation, atherosclerosis, violation of blood flow, arteries of lower extremities

Downloads

Download data is not yet available.

References

Литература

Шальнова С. А.Эпидемиология сердечно-сосудистых заболеваний и факторы риска в России // Кардиология: национальное руководство / под ред. Ю. Н. Беленкова, Р. Г. Оганова. М.:ГЭОТАР-Медиа, 2010. С. 37–52.

Карпенко А. А., Стародубцев В. Б., Игнатенко П. В., Золоев Д. Г.Гибридные оперативные вмешательства у пациентов с многоуровневым атеросклеротическим поражением артерий нижних конечностей // Ангиология и сосудистая хирургия. 2014. Т. 20, № 2. C. 60–65.

Гавриленко А. В., Егоров А. А., Котов А. Э., Мамухов А. С., Молокопой С. Н. Хирургическое лечение больных с атеросклеротической окклюзией аорто-подвздошного сегмента в сочетании с поражением дистального русла // Ангиология и сосудистая хирургия. 2012. Т. 18, № 3. C. 101–105.

Пшеничный В. Н., Штутин А.А., Иваненко А. А., Воропаев В. В., Ковальчук О. Н., Гаевой В. Л.Эффективность двухуровневых инфраингвинальных реконструкций в лечении хронической критической ишемии нижних конечностей // Ангиология и сосудистая хирургия. 2012. Т. 18, № 3. C. 132–137.

Покровский А. В.Заболевания аорты и ее ветвей. М.: Медицина. 1979. 324 с.

Rutherford R. В., Baker J. D., Ernst С., Johnston K. W., Porter J. M., Ahn S., Jones D. N.Recommended standarts for reports dealing with lower extremity ischemia Revised version // J. Vasc. Surg. 1997.Vol. 26, N 3. P. 516–538.

Российский консенсус «Рекомендуемые стандарты для оценки результатов лечения пациентов с хронической ишемией нижних конечностей». М., 2001. 29 c.

Suggested standarts for reports dealing with lower extremity ischemia Prepared by Ad Hoc Committee on Reporting Standarts, SVS/ISCVS // J. Vasc. Surg. 1986. Vol. 4, N 1. P. 80–94.

Albäck A., Roth W. D., Ihlberg L., Biancari F., Lepäntalo M.Preoperative angiographic score and in-traoperative flow as predictors of the midterm patency of infrapopliteal bypass grafts // Eur. J. Vasc.Endovasc. Surg. 2000. Vol. 20, N 5. P. 447–453.

Ljungman C., Ulus A. T., Almgren B., Bergström R., Hellberg A., Bergqvist D., Karacagil S.Amultivariate analysis of factors affecting patency of femoropopliteal and femorodistal bypass grafting // Vasa. 2000. Vol. 29, N 3. P. 215–220.

Покровский А. В., Дан В. Н., Чупин А. В., Харазов А. Ф.Можно ли предсказать исход реконструктивной операции у больных с ишемией нижних конечностей на основании дооперационных исследований? // Ангиология и сосудистая хирургия. 2002. Т. 8, № 3. C. 102–110.

Бегун П. И., Кривохижина О. В., Сухов В. К. Компьютерное моделирование и биомеханический анализ критического состояния и коррекции структур сосудистой системы (Ч. I) // Управление в медицине и биологии. 2005. № 6. С. 51–56.

Бондаренко М. А., Лебедева Е. А., Артюшин Б. С. Биомеханический метод исследования влияния атеросклеротических поражений на гемодинамику в артериях нижних конечностей // Известия СПбГЭТУ «ЛЭТИ». 2015. № 9. С. 85–89.

References

Shal’nova S. A. Epidemiologiia serdechno-sosudistykh zabolevanii i faktory riska v Rossii [Epidemiology of cardiovascular diseases and risk factors in Russia].Kardiologiia: natsional’noe rukovodstvo[Cardiology:national leadership].Eds. Iu. N. Belenkov, R. G. Oganov. Moscow, GEOTAR-Media Publ., 2010, pp. 37–52.(In Russian)

Karpenko A. A., Starodubtsev V. B., Ignatenko P. V., Zoloev D. G. Gibridnye operativnye vmeshatel’stva u patsientov s mnogourovnevym ateroskleroticheskim porazheniem arterii nizhnikh konechnostei [Hybrid operative interventions in patients with multilevel atherosclerotic lesions of arteries of lower extremities].Angiology and vascular surgery,2014, vol. 20, no. 2, pp. 60–65. (In Russian)

Gavrilenko A. V., Egorov A. A., Kotov A. E., Mamukhov A. S., Molokopoi S. N. Khirurgicheskoe lechenie bol’nykh s ateroskleroticheskoi okkliuziei aorto-podvzdoshnogo segmenta v sochetanii s porazheniem distal’nogo rusla [Surgical treatment of patients with atherosclerotic occlusion of the aorto-iliac segment in combination with a lesion of the distal bed].Angiology and vascular surgery,2012, vol. 18, no. 3, pp. 101–105. (In Russian)

Pshenichnyi V. N., Shtutin A. A., Ivanenko A. A., Voropaev V. V., Koval’chuk O. N., Gaevoi V. L.Effektivnost’ dvukhurovnevykh infraingvinal’nykh rekonstruktsii v lechenii khronicheskoi kriticheskoi ishemii nizhnikh konechnostei [Efficiency duplex infrainguinal reconstructions in treatment of chronic critical ischemia of lower extremities].Angiology and vascular surgery,2012, vol. 18, no. 3,pp. 132–137. (In Russian)

Pokrovskii A. V.Zabolevaniia aorty i ee vetvei [Diseases of the aorta and its branches].Moscow, Medicine Publ., 1979. 324 p. (In Russian)

Rutherford R. В., Baker J. D., Ernst С., Johnston K. W., Porter J. M., Ahn S., Jones D. N. Recommended standarts for reports dealing with lower extremity ischemia Revised version.J. Vasc.Surg.,1997,vol. 26, no. 3, pp. 516–538.

Rossiiskii konsensus «Rekomenduemye standarty dlia otsenki rezul’tatov lecheniia patsientov s khronicheskoi ishemiei nizhnikh konechnostei» [Russian consensus “Recommended standards for evaluation of results of treatment of patients with chronic ischemia of lower extremities”]. Moscow,2001. 29 p. (In Russian)

Suggested standarts for reports dealing with lower extremity ischemia Prepared by Ad Hoc Committee on Reporting Standarts, SVS/ISCVS. J. Vasc. Surg.,1986, vol. 4, no. 1, pp. 80–94.

Albäck A., Roth W. D., Ihlberg L., Biancari F., Lepäntalo M. Preoperative angiographic score and in-traoperative flow as predictors of the midterm patency of infrapopliteal bypass grafts.Eur. J. Vasc.Endovasc. Surg.,2000, vol. 20, no. 5, pp. 447–453.

Ljungman C., Ulus A. T., Almgren B., Bergström R., Hellberg A., Bergqvist D., Karacagil S. A multi-variate analysis of factors affecting patency of femoropopliteal and femorodistal bypass grafting.Vasa,2000, vol. 29, no. 3, pp. 215–220. (In Russian)

Pokrovskii A. V., Dan V. N., Chupin A. V., Kharazov A. F. Mozhno li predskazat’ iskhod rekonstruktivnoi operatsii u bol’nykh s ishemiei nizhnikh konechnostei na osnovanii dooperatsionnykh issledovanii? [Can we predict the outcome of reconstructive surgery in patients with lower limb ischaemia on the basis of preoperative studies?]. Angiology and vascular surgery,2002, vol. 8, no. 3, pp. 102–110. (In Russian)

Begun P. I., Krivokhizhina O. V., Sukhov V. K. Komp’iuternoe modelirovanie i biomekhanicheskii analiz kriticheskogo sostoianiia i korrektsii struktur sosudistoi sistemy (Chast’ I) [Computer simulation and biomechanical analysis of critical state and correction of the structures of the vascular system (Part I)].Management in medicine and biology,2005, no. 6, pp. 51–56. (In Russian)

Bondarenko M. A., Lebedeva E. A., Artiushin B. S. Biomekhanicheskii metod issledovaniia vliianiia ateroskleroticheskikh porazhenii na gemodinamiku v arteriiakh nizhnikh konechnostei

[Biomechanical technique to investigate the influence of atherosclerotic lesions on hemodynamics in the arteries of the lower extremities].News of Saint-Petersburg State electrotechnical University “LETI”,2015, no. 9, pp. 85–89. (In Russian)