A computational fluid dynamics study pre-and post-stent graft placement in an acute type B aortic dissection

Purpose: To demonstrate the capability of computational fluid dynamics (CFD) for quantifying hemodynamic forces pretreatment/posttreatment in type B aortic dissection (TB-AD). Methods: From CFD simulations initialized with dynamic magnetic resonance image data, wall shear stress (WSS) and dynamic pressure (dynP) changes post endovascular treatment were quantified. Results: After 1 year follow-up, thoracic aortic segment was completely remodeled, and persistent, nonthrombosed false lumen in the abdominal aorta was noted. Pretreatment, large WSS (>5 Pa) and dynP (>80 Pa) occurred at entrance tear and a stenotic region in the true lumen (TL). Posttreatment, WSS was lower than 3.3 Pa and dynP was lower than 55 Pa in TL, except at proximal end of the stent graft and at reentrance tear. Two focal locations of high dynP existed within the stent graft. Conclusions: Computational fluid dynamics may provide quantitative assessment of hemodynamic wall forces in TB-AD potentially of interest for follow-up examinations.