Brendan M Stanley

Publications (3)5.35 Total impact

• Article: Stress and strain behaviour modelling of the carotid bifurcation.

  Michael Lawrence-Brown, Brendan M Stanley, Zhonghua Sun, James B Semmens, Kurt Liffman
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  ABSTRACT: The aim of this study is to investigate the biomechanical stress and strain behaviour within the wall of the artery and its influence on plaque formation and rupture using computational fluid dynamics (CFD). A three-dimensional finite-element model of the carotid bifurcation was generated to analyse the wall stress and strain behaviour. Both single-layer and multilayer models were created and structural analysis was compared between these two types of models. Systolic pressure of 180 mm Hg (~24 kPa) was applied in the inner boundary of the carotid bifurcation, and CFD analysis was performed to show the wall shear stress and pressure. The highest wall stress was found at the carotid bifurcation. When a high blood pressure (280 mm Hg) was applied to the carotid CFD model, the results showed that the stress at the carotid bifurcation may reach the rupture value. The multilayer carotid bifurcation model behaved differently from the equivalent single-layer model, with peak stress (Von-Mises) being higher in the multilayer model. The peak stress and strain was located at the origins of the internal and external carotid arteries. Significant shearing occurred between the layers in the wall of the artery at the bifurcation. Intramural shear stress in the CFD multilayer model has potential for intramural vascular injury. This may be responsible for plaque formation, plaque rupture and an injury/healing cycle.
  ANZ Journal of Surgery 11/2011; 81(11):810-6. · 1.25 Impact Factor
• Article: Outcome of endoleak following endoluminal abdominal aortic aneurysm repair.

  Daniel M Mandziak, Brendan M Stanley, Robert K Foreman, John A Walsh, Jim R Burnett
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  ABSTRACT: The most important complication of endoluminal abdominal aortic aneurysm repair is endoleak, in which there is persistent blood flow outside the graft but within the aneurysm sac. Depending on endoleak type, there is an ongoing potential for aneurysm expansion or rupture. Conversely, some endoleaks may resolve spontaneously. Absolute indications for interventional management of endoleaks remain elusive due to the heterogeneous nature of leaks and uncertainty in predicting their outcome. A retrospective review was conducted on all endoluminal graft recipients with endoleaks at Repatriation General Hospital over a 3-year period. Data were collected via a database maintained by the Department of Vascular Surgery, and hospital casenotes. Sixty-six patients underwent endoluminal graft insertion in the study period. Fourteen endoleaks were observed in 11 patients, representing an endoleak rate of 21.2%. There were three type I leaks and 11 type II leaks. One type I leak resolved spontaneously, one resolved immediately following interventional management, and one resolved 6 months after interventional management. Interventional treatment was undertaken in seven cases of type II leak due to increase in aneurysm diameter by 5 mm. Two type II endoleaks resolved spontaneously. Aneurysm diameter increased in two patients following radiographic resolution of their endoleaks. There were no cases of aneurysm rupture. Initial observation is a reasonable management option in most cases of type II endoleak, because some will spontaneously resolve during follow up. Those associated with increase in aneurysm size should undergo interventional treatment. Conservative management of type I endoleaks may be undertaken in extreme isolated cases.
  ANZ Journal of Surgery 01/2005; 74(12):1039-42. · 1.25 Impact Factor
• Article: Endoluminal repair of mycotic thoracic aneurysms.

  Brendan M Stanley, James B Semmens, Michael M D Lawrence-Brown, Michael Denton, David Grosser
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  ABSTRACT: To report a series of endoluminally repaired mycotic thoracic aneurysms. Four patients with presumed mycotic aneurysms of the thoracic aorta were treated with endovascular grafts owing to overly high risk for open repair. All aneurysms were successfully excluded at the initial intervention. In one case, which required endograft fenestrations for the superior mesenteric and renal arteries, the patient died 53 days after the procedure, following graft migration and occlusion of major branch vessels. The other 3 patients remain alive and well at a mean follow-up of 16 months with no signs of ongoing sepsis. Endoluminal repair of thoracic mycotic aneurysms is technically feasible and, in association with long-term antibiotics, offers at least temporary protection against imminent rupture.
  Journal of Endovascular Therapy 07/2003; 10(3):511-5. · 2.86 Impact Factor