Abstract：
Pre-procedural planning of thoracic endovascular aortic repair (TEVAR) may implement computational adjuncts to predict technical and clinical outcomes. The aim of this scoping review was to explore the currently available TEVAR procedure and stent graft modelling options.
PubMed (MEDLINE), Scopus, and Web of Science were systematically searched (English language, up to 9 December 2022) for studies presenting a virtual thoracic stent graft model or TEVAR simulation.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was followed. Qualitative and quantitative data were extracted, compared, grouped, and described. Quality assessment was performed using a 16 item rating rubric.
Fourteen studies were included. Among the currently available in silico simulations of TEVAR, severe heterogeneity exists in study characteristics, methodological details, and evaluated outcomes. Ten studies (71.4%) were published during the last five years. Eleven studies (78.6%) included heterogeneous clinical data to reconstruct patient specific aortic anatomy and disease (e.g., type B aortic dissection, thoracic aortic aneurysm) from computed tomography angiography imaging. Three studies (21.4%) constructed idealised aortic models with literature input. The applied numerical methods consisted of computational fluid dynamics analysing aortic haemodynamics in three studies (21.4%) and finite element analysis analysing structural mechanics in the others (78.6%), including or excluding aortic wall mechanical properties. The thoracic stent graft was modelled as two separate components (e.g., graft, nitinol) in 10 studies (71.4%), as a one component homogenised approximation (n = 3, 21.4%), or including nitinol rings only (n = 1, 7.1%). Other simulation components included the catheter for virtual TEVAR deployment and numerous outcomes (e.g., Von Mises stresses, stent graft apposition, drag forces) were evaluated.
This scoping review identified 14 severely heterogeneous TEVAR simulation models, mostly of intermediate quality. The review concludes there is a need for continuous collaborative efforts to improve the homogeneity, credibility, and reliability of TEVAR simulations.
PubMed (MEDLINE), Scopus, and Web of Science were systematically searched (English language, up to 9 December 2022) for studies presenting a virtual thoracic stent graft model or TEVAR simulation.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was followed. Qualitative and quantitative data were extracted, compared, grouped, and described. Quality assessment was performed using a 16 item rating rubric.
Fourteen studies were included. Among the currently available in silico simulations of TEVAR, severe heterogeneity exists in study characteristics, methodological details, and evaluated outcomes. Ten studies (71.4%) were published during the last five years. Eleven studies (78.6%) included heterogeneous clinical data to reconstruct patient specific aortic anatomy and disease (e.g., type B aortic dissection, thoracic aortic aneurysm) from computed tomography angiography imaging. Three studies (21.4%) constructed idealised aortic models with literature input. The applied numerical methods consisted of computational fluid dynamics analysing aortic haemodynamics in three studies (21.4%) and finite element analysis analysing structural mechanics in the others (78.6%), including or excluding aortic wall mechanical properties. The thoracic stent graft was modelled as two separate components (e.g., graft, nitinol) in 10 studies (71.4%), as a one component homogenised approximation (n = 3, 21.4%), or including nitinol rings only (n = 1, 7.1%). Other simulation components included the catheter for virtual TEVAR deployment and numerous outcomes (e.g., Von Mises stresses, stent graft apposition, drag forces) were evaluated.
This scoping review identified 14 severely heterogeneous TEVAR simulation models, mostly of intermediate quality. The review concludes there is a need for continuous collaborative efforts to improve the homogeneity, credibility, and reliability of TEVAR simulations.
摘要：
目的：胸主动脉腔内修复术（TEVAR）的术前计划可以实施计算辅助手段来预测技术和临床结果。本次范围审查的目的是探索当前可用的TEVAR程序和支架移植物建模选项。
方法：PubMed(MEDLINE)，Scopus,和WebofScience进行了系统搜索(英语，截至2022年12月9日），用于介绍虚拟胸部支架移植模型或TEVAR模拟的研究。
方法：遵循系统评论和Meta分析扩展范围评论（PRISMA-ScR）的首选报告项目。提取了定性和定量数据，比较,分组,并描述。使用16项评级标准进行质量评估。
结果：共纳入14项研究。在目前可用的TEVAR计算机模拟中，研究特征存在严重的异质性，方法细节，并评估结果。在过去五年中发表了十项研究（71.4％）。11项研究(78.6%)包括异质性临床数据，以重建患者特定的主动脉解剖结构和疾病(例如，B型主动脉夹层,胸主动脉瘤）来自计算机断层扫描血管造影成像。三项研究（21.4％）构建了理想化的主动脉模型，并输入了文献。应用的数值方法包括在三项研究中分析主动脉血流动力学的计算流体动力学（21.4％）和在其他研究中分析结构力学的有限元分析（78.6％）。包括或不包括主动脉壁机械性能。胸部支架移植物被建模为两个单独的组件(例如，移植,镍钛诺)在10项研究中(71.4%)，作为单组分均匀化近似(n=3，21.4%)，或仅包括镍钛诺环(n=1,7.1%)。其他模拟组件包括用于虚拟TEVAR部署的导管和许多结果(例如，VonMises强调,支架移植物并置,阻力)进行了评估。
结论：这项范围审查确定了14个严重异质的TEVAR模拟模型，主要是中等质量。审查得出的结论是，需要不断的合作努力来改善同质性，信誉,和TEVAR模拟的可靠性。
方法：PubMed(MEDLINE)，Scopus,和WebofScience进行了系统搜索(英语，截至2022年12月9日），用于介绍虚拟胸部支架移植模型或TEVAR模拟的研究。
方法：遵循系统评论和Meta分析扩展范围评论（PRISMA-ScR）的首选报告项目。提取了定性和定量数据，比较,分组,并描述。使用16项评级标准进行质量评估。
结果：共纳入14项研究。在目前可用的TEVAR计算机模拟中，研究特征存在严重的异质性，方法细节，并评估结果。在过去五年中发表了十项研究（71.4％）。11项研究(78.6%)包括异质性临床数据，以重建患者特定的主动脉解剖结构和疾病(例如，B型主动脉夹层,胸主动脉瘤）来自计算机断层扫描血管造影成像。三项研究（21.4％）构建了理想化的主动脉模型，并输入了文献。应用的数值方法包括在三项研究中分析主动脉血流动力学的计算流体动力学（21.4％）和在其他研究中分析结构力学的有限元分析（78.6％）。包括或不包括主动脉壁机械性能。胸部支架移植物被建模为两个单独的组件(例如，移植,镍钛诺)在10项研究中(71.4%)，作为单组分均匀化近似(n=3，21.4%)，或仅包括镍钛诺环(n=1,7.1%)。其他模拟组件包括用于虚拟TEVAR部署的导管和许多结果(例如，VonMises强调,支架移植物并置,阻力)进行了评估。
结论：这项范围审查确定了14个严重异质的TEVAR模拟模型，主要是中等质量。审查得出的结论是，需要不断的合作努力来改善同质性，信誉,和TEVAR模拟的可靠性。
