3D Morphologic Findings Before and After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection

Sun, Weiya; Xu, Huanming; Xiong, Jiang; Li, Zhenfeng; Chen, Yang; Yang, Guanyu; Hu, Shu; Chen, Duanduan

doi:10.1016/j.avsg.2020.12.026

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Weisun et al used 3D rendering technology to explain the hemodynamics of the descending aorta after aortic dissection stent implantation, which also provided clear ideas and evidence. 3D rendering technology can be used in the analysis of aortic arch blood ow [11] . A. Osswald et al used 3D simulation technology to detect the pressure, WSS, ow velocity, etc., at different positions; they made 3D renderings to understand the pressure situation and pressure difference at different positions and suggested that WSS at different positions was an important index that affected the formation of the interlayer.…”

Section: Discussionmentioning

confidence: 99%

A 3D-simulation hemodynamic study of the correlation between aortic arch morphology and aortic dissection

Wang,

Liang,

et al. 2023

Preprint

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Background Reverse tearing and the correlation between aortic arch morphology and aortic dissection were studied with a 3D simulation hemodynamic technique. Methods From 2018 to 2023, 140 patients with aortic dissection admitted to Suzhou Hospital affiliated with Nanjing Medical University and Guangyuan First People's Hospital (age 56.5 ± 12.0 years; 52 female) and 143 healthy controls (age 53.1 ± 11.8 years; 50 female) underwent CTA examination of the whole thoracic and abdominal aorta; the diameter of the three branches of the aortic arch, the angle of the branches, the distance of the branches and the type of the aortic arch were recorded and analyzed. By adjusting the parameter values of risk factors, the morphology of the aortic arch and its branches was simulated, and the regional differences in blood flow velocity and shear force in the 3D simulation experiment were used to evaluate the hemodynamics of the aortic arch. Results Compared with healthy controls, patients with aortic dissection had an angle of the left subclavian artery (OR = 0.841, 95% CI = 0.752–0.942, P = 0.003). The length of the ascending aorta (OR = 0.935, 95% CI = 0.885–0.998, P = 0.017). The bifurcation of the LSA in patients with aortic dissection is the position where WSS in the aortic arch is the highest (compared with other parts of the aortic arch). Compared with patients with nonaortic dissection, the left subclavian artery angle WSS significantly differed. The location of the damaged dissection was categorized as type 1 (Z3) and type 2 (Z2 + Z3). The comparative analysis of the data on the arch in the two groups indicated that the left subclavian angle (P < 0.05) was an independent risk factor. The maximum shear force of the aortic arch was at the LSA bifurcation, and the WSS mean of type 1 and type 2 (10.48 ± 3.09 vs. 21.57 ± 7.31 Pa, p = 0.0001). The LPD of type 1 and type 2 (2.53 ± 2.14 vs. 13.83 ± 8.87 Pa, p = 0.0001). Conclusion The angle of the left subclavian artery and the length of the ascending aorta are independent risk factors for the formation of aortic dissection. Aortic dissection patients receive the greatest shear pressure at the bifurcation of the left subclavian artery and aorta, which is the common location of dissection. The small angle of the left subclavian artery is an independent risk factor for dissection avulsion.

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Section: Discussionmentioning

confidence: 99%

A 3D-simulation hemodynamic study of the correlation between aortic arch morphology and aortic dissection

Wang,

Liang,

et al. 2023

Preprint

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“…Multivariate analysis found that the diameter of the TL impacted remodeling of the total aorta at the celiac trunk level because the risk of residual tears of the celiac trunk was greater than that at other levels ( 22 ). In addition, the accuracy of measurements of the aortic diameter should be improved, it was best to use the artificial intelligence.…”

Section: Discussionmentioning

confidence: 99%

Preoperative diameters of aorta influence the remodeling after surgery for type A aortic dissection

Zhang,

Yang,

Gao

et al. 2023

J Thorac Dis

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Background Although current research revealed the preoperative diameter of the aorta is related to aortic remodeling, prognosis should consider the true lumen (TL) and false lumen (FL) respectively too. Methods The cohort of this retrospective analysis included 161 type A aortic dissection (TAAD) patients who underwent surgery at a single institution from September 1, 2017, to September 1, 2018. Computed tomography angiography (CTA) images were reviewed to assess changes of the diameters of the TL, FL and total aorta at the levels of the stented segment, distal end of the stent, celiac trunk, and below the renal artery. Results During the study period, positive remodeling was observed in 33 (20.5%) patients. The probability of negative remodeling far from the stent segment was greater than the aorta close to the stent. Only the TL diameter was associated with each levels’ changes and underwent significant change (P<0.05). Multivariate analysis identified aortic regurgitation as a risk factor for remodeling in the distal end of the stent. The maximum diameter of the FL was the only risk factor related to the remodeling type (odds ratio =0.10; 95% confidence interval: 0.01–0.51), a maximum diameter of the FL of >1.28 cm was associated with a higher probability of negative remodeling after surgery (specificity =0.994; sensitivity =0.571; area under the receiver operating characteristic curve =0.76). Conclusions The TL and FL diameters on preoperative CTA images can be used to assess the risk of negative remodeling after surgery.

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Influence of thoracic endovascular aortic repair on true lumen helical morphology for Stanford type B dissections

Bondesson

Suh

Marks

et al. 2021

Journal of Vascular Surgery

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3D Morphologic Findings Before and After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection

Cited by 5 publications

References 25 publications

A 3D-simulation hemodynamic study of the correlation between aortic arch morphology and aortic dissection

A 3D-simulation hemodynamic study of the correlation between aortic arch morphology and aortic dissection

Preoperative diameters of aorta influence the remodeling after surgery for type A aortic dissection

Influence of thoracic endovascular aortic repair on true lumen helical morphology for Stanford type B dissections

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