Résumé
L’évaluation du risque de rupture d’une pathologie de l’aorte uniquement sur la base du diamètre maximum est tout à fait insufsante et les critères doivent tenir compte de deux paramètres essentiels, l’augmentation de la pression pariétale et la diminution de la résistance de la paroi. Pour ces diférentes raisons, de nombreuses études hémodynamiques ont été réalisées ces dernières années sur la pathologie aortique. Celles-ci ont montré les limites de la loi de Laplace et l’intérêt de l’évaluation par les CFD de diférents paramètres hémodynamiques. Ces évaluations mathématiques permettent d’apprécier les diférentes forces régnant au sein de la lumière vasculaire ainsi que sur la paroi in vivo.
Les développements futurs de ces modèles d’évaluation de la rhéologie de la paroi aideront sans aucun doute la prise de décision thérapeutique et la surveillance des procédures endovasculaires.
En ayant ces outils, des études prospectives devraient valider ces méthodes et préciser la place de ces nouvelles techniques d’imagerie et fonctionnelles pour la décision thérapeutique.
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Rousseau, H. et al. (2011). Imagerie des flux aortiques par IRM et mécanique des fuides: applications cliniques sur la pathologie aortique thoracique. In: Imagerie en coupes du coeur et des vaisseaux. Springer, Paris. https://doi.org/10.1007/978-2-8178-0154-4_2
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DOI: https://doi.org/10.1007/978-2-8178-0154-4_2
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