Identifying Hemodynamic Predictors of Aortic Growth After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection

CFD simulation demonstrated that elevated pressure and increased OSI in false lumen could independently predict aortic growth following TEVAR. Monitoring these specific metrics could help identify high-risk patients immediately after stent graft implantation. However, the predictive value of these predictors was low, indicating a need for larger sample, higher-quality studies to validate these findings.Clinical ImpactThoracic endovascular aortic repair (TEVAR) is the important treatment for patients with acute type B aortic dissection (TBAD). However, aortic growth following TEVAR remains an important unresolved issue. Previous case/ cases reports found aortic growth was not solely driven by anatomical factors but influenced by hemodynamics within the false lumen. However, no further higher-quality studies supported the conclusion. In this comparative study, aortic growth and non-growth groups were divided. The computational fluid dynamics (CFD) simulation showed that elevated pressure and oscillatory shear index (OSI) in the false lumen could independently predict aortic growth after TEVAR. Our conclusions allowed vascular surgeons to make a decision on further intervention for distal aortic dissection immediately after stent graft implantation, to prevent potentially post-dissection aortic aneurysm (PDAA) and rupture in the future.