Analysis of aortic wall stress and morphology in Patients with Type B aortic dissection

Pregnancy increases aortic wall stress and, for a woman with a chronic dissection, this can lead to extension of the dissection, aortic rupture, and death. We report a pregnancy in a woman with a history of a chronic type B aortic dissection. As a child, she had repeat balloon dilation of aortic coarctation, and one of the procedures was complicated by an iatrogenic dissection at the dilation site. At the age of 27 years, she had a planned pregnancy.

Download Full-text

IP073. Predicting Aortic Remodeling After Thoracic Aortic Endovascular Repair for Stanford Type B Aortic Dissection Using Aortic Wall Thickness Ratios

Journal of Vascular Surgery ◽

10.1016/j.jvs.2019.04.160 ◽

2019 ◽

Vol 69 (6) ◽

pp. e131

Author(s):

Jesus F. Vasquez ◽

Idine Mousavi ◽

James F. McKinsey ◽

Michael L. Marin ◽

Peter L. Faries ◽

...

Keyword(s):

Aortic Dissection ◽

Wall Thickness ◽

Endovascular Repair ◽

Aortic Wall ◽

Type B ◽

Type B Aortic Dissection ◽

Aortic Wall Thickness ◽

Aortic Remodeling ◽

Stanford Type B

Download Full-text

Dissection Level Within Aortic Wall Layers is Associated with Propagation of Type B Aortic Dissection: A Swine Model Study

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2019.02.026 ◽

2019 ◽

Vol 58 (3) ◽

pp. 415-425

Author(s):

Baolei Guo ◽

Zhihui Dong ◽

Selene Pirola ◽

Yifan Liu ◽

Claudia Menichini ◽

...

Keyword(s):

Aortic Dissection ◽

Aortic Wall ◽

Swine Model ◽

Type B ◽

Type B Aortic Dissection ◽

Model Study

Download Full-text

Patient-specific simulation of stent-graft deployment in type B aortic dissection: model development and validation

Biomechanics and Modeling in Mechanobiology ◽

10.1007/s10237-021-01504-x ◽

2021 ◽

Author(s):

Xiaoxin Kan ◽

Tao Ma ◽

Jing Lin ◽

Lu Wang ◽

Zhihui Dong ◽

...

Keyword(s):

Blood Pressure ◽

Aortic Dissection ◽

Stent Graft ◽

Aortic Wall ◽

Computational Simulation ◽

Model Complexity ◽

Patient Specific ◽

Uniaxial Tensile ◽

Type B ◽

Type B Aortic Dissection

AbstractThoracic endovascular aortic repair (TEVAR) has been accepted as the mainstream treatment for type B aortic dissection, but post-TEVAR biomechanical-related complications are still a major drawback. Unfortunately, the stent-graft (SG) configuration after implantation and biomechanical interactions between the SG and local aorta are usually unknown prior to a TEVAR procedure. The ability to obtain such information via personalised computational simulation would greatly assist clinicians in pre-surgical planning. In this study, a virtual SG deployment simulation framework was developed for the treatment for a complicated aortic dissection case. It incorporates patient-specific anatomical information based on pre-TEVAR CT angiographic images, details of the SG design and the mechanical properties of the stent wire, graft and dissected aorta. Hyperelastic material parameters for the aortic wall were determined based on uniaxial tensile testing performed on aortic tissue samples taken from type B aortic dissection patients. Pre-stress conditions of the aortic wall and the action of blood pressure were also accounted for. The simulated post-TEVAR configuration was compared with follow-up CT scans, demonstrating good agreement with mean deviations of 5.8% in local open area and 4.6 mm in stent strut position. Deployment of the SG increased the maximum principal stress by 24.30 kPa in the narrowed true lumen but reduced the stress by 31.38 kPa in the entry tear region where there was an aneurysmal expansion. Comparisons of simulation results with different levels of model complexity suggested that pre-stress of the aortic wall and blood pressure inside the SG should be included in order to accurately predict the deformation of the deployed SG.

Download Full-text