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The following is a summary of “Exploring hemodynamic mechanisms and re-intervention strategies for partial false lumen thrombosis in Stanford type B aortic dissection after thoracic aortic endovascular repair,” published in the December 2024 issue of Cardiology by Wang et al.
People living with Stanford type B aortic dissection (TBAD) who undergo thoracic endovascular aortic repair (TEVAR) often experience challenges with false lumen (FL) thrombosis, which affects long-term outcomes and aortic remodeling.
Researchers conducted a retrospective study to evaluate the morphology, hemodynamics, and re-intervention strategies for partial false lumen thrombosis (PFLT) in people with Stanford TBAD after TEVAR.
They analyzed three-dimensional geometries from computed tomography angiography (CTA) scans over a five-year follow-up in individuals living with Stanford TBAD after TEVAR. The team assessed the morphologic evolution of partial false lumen thrombosis and related hemodynamic factors using patient-specific reconstructions and computational fluid dynamics (CFD). Simulations were conducted to evaluate the impact of interventions, including proximal entry closure, left renal artery stenting, and accessory renal artery embolism, on hemodynamic conditions.
The results showed that the false lumen progressively dilated, with surface area increasing from 82.63 cm2 to 98.84 cm2 and volume increasing from 45.12 mL to 63.40 mL. The size of the distal tear increased from 3.72 cm to 4.32 cm, and fluctuations were observed in the thrombosis-blood lumen boundary. Simulated re-interventions, including proximal entry closure, left renal artery stenting, and accessory renal artery embolism, demonstrated the potential to suppress adverse hemodynamic conditions within the partial false lumen thrombosis, providing insights for surgical planning.
They concluded that combining morphologic and hemodynamic analyses offers a valuable strategy for monitoring and planning re-intervention in individuals with partial false lumen thrombosis after TEVAR for Stanford TBAD.
Source: sciencedirect.com/science/article/abs/pii/S0167527324011161
