Analysis of aortic wall stress and morphology in patients with type B aortic dissection

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