Key result
Tear site wall stress differs by initial intimal tear location in type B aortic dissection.
Why the study?
Risk assessment is critical in preventing aortic dissection, but wall stress distribution and aortic shape needed evaluation to explore the pathogenesis of type B aortic dissection.
Cross-Sectional (n=30)
p-value: p=<0.001
Abnormal head vessel angles and wall stress distribution assessed via finite element analysis may serve as important biomechanical risk factors and predictors for the location of tears in type B aortic dissection.
May support biomechanical risk stratification in type B aortic dissection; leaves open prospective validation before clinical adoption.
Risk assessment is critical in preventing aortic dissection (AD). This study aims to evaluate the wall stress (WS) distribution, especially at the locations of proximal tears in patient-specific type-B aortic dissection (TBAD) to explore the pathogenesis of dissection. In addition, the shape of the aortas were assessed and associated with TBAD risk. In this paper, 30 three-dimensional models were reconstructed based on patient-specific CT angiography images, and finite element analysis (FEA) was used to analyze the admission blood pressure. In addition, the anatomic variables including the head vessel angles, the aorta diameters, curvatures and torturosity ware measured. Tears occurred at either local high WS or low WS region, and these acute TBAD patients can be classified into three groups based on the location of initial intimal tears. In addition, the WS values at tear sites of each group showed significant difference (P＜0.001). Moreover, the angles of the left subclavian and brachiocephalic arteries were statistical different among three groups. Increased wall stress or decreased wall strength both contribute to the pathogenesis of aortic dissections. In addition, abnormal head vessel angles may be monitored as an important risk factor for aortic dissection, and its specific features may further help to determine the potential tear location.
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Hu et al. (2021) conducted a cross-sectional in type B aortic dissection (n=30). Wall stress and aortic morphology was evaluated on Wall stress values at tear sites (p=<0.001). Wall stress values at tear sites differed significantly among three groups of patients with type B aortic dissection classified by initial intimal tear location (P<0.001).