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This computational study aims to understand which is the effect of calcification on stent graft displacement after TEVAR procedure, simulated in a patient-specific anatomy with a penetrating aortic ulcer (PAU).<\/jats:p>\n                  <jats:p>A patient-specific anatomy without calcification is taken as reference, and four models with idealized calcifications positioned in different regions and with different material properties are analyzed. Opening area, von Mises stresses and contact pressures are evaluated to provide a reliable comparison between the calcified (Ca) and the non-calcified models (noCa), and among the calcified models themselves.<\/jats:p>\n                  <jats:p>Comparing qualitatively the Ca and noCa models, no particular changes in the stent graft apposition are observed. In addition, in the Ca models the opening area results lower with respect to the noCa models, but no significant differences are observed among the Ca models. Regarding the von Mises stresses, it seems that the calcifications act as load-bearing structures, absorbing the stresses and reducing them on the aorta. Decreasing the Young modulus of the calcifications, this effect is reduced. Higher contact pressures are observed when the highest Young\u2019s modulus of calcification is adopted, with all Ca models having greater pressures than the noCa model.<\/jats:p>\n                  <jats:p>From this analysis, the stent graft seems to be positioned correctly inside the aorta, even in the presence of calcifications. In this setting, the calcifications seem to reduce the stresses on the aorta, thus reducing the likelihood of aneurysm rupture.<\/jats:p>","DOI":"10.1007\/s10237-025-01998-9","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T12:40:02Z","timestamp":1757680802000},"page":"1913-1926","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing calcification effects in TEVAR procedures: a computational analysis"],"prefix":"10.1007","volume":"24","author":[{"given":"Giulia","family":"De Campo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Ramella","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Barati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0434-8544","authenticated-orcid":false,"given":"Giulia","family":"Luraghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Fregona","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Domanin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Heijmen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santi","family":"Trimarchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Migliavacca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"1998_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2023.107727","volume":"240","author":"A Aldieri","year":"2023","unstructured":"Aldieri A, Curreli C, Szyszko JA et al (2023) Credibility assessment of computational models according to ASME V&V40: application to the Bologna biomechanical computed tomography solution. 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AR, SB, GL, FM reports a relationship with AllStent s.r.l. that includes: equity or stocks. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}