ABSTRACT Hemodynamic evaluation using four‐dimensional flow magnetic resonance imaging or computational fluid dynamics can identify a high‐risk phenotype in Kommerell's diverticulum, which is characterized by intradiverticular vortex formation, low wall shear stress, and elevated oscillatory shear index (OSI). This functional assessment provides crucial risk stratification beyond anatomical size, as a high OSI may pinpoint intimal vulnerability sites and potential dissection entry.
Sakakibara et al. (Wed,) studied this question.