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We identified cases with more than 5\u00a0mm enlargement at the distal FET level during follow-up and performed statistical analyses. Among these, patients with contrast-enhanced CT were analyzed using CFD. Study 2 used idealized aorta\u2013stent graft models with different aorto-stent graft angles (AS angle) to isolate the hemodynamic effect of angulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In Study 1, larger AS angle was associated with subsequent aortic enlargement, and a cutoff around 38.3\u00b0 suggested higher risk. CFD tended to show disturbed\/recirculating flow along the lesser curvature in high-angle cases, with lower WSS and higher OSI at the distal FET level. In Study 2, increasing AS angle accentuated lesser-curvature flow disturbance and increased greater-curvature WSS; Pearson correlations suggested a positive association between AS angle and greater-curvature WSS\/TAWSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A larger AS angle may be associated with enlargement of the distal aorta after FET. Larger and more precise studies are warranted to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-026-04095-9","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T12:22:32Z","timestamp":1776514952000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computational fluid dynamics analysis for enlargement of the descending aorta after frozen elephant trunk implantation"],"prefix":"10.1186","volume":"21","author":[{"given":"Hiroki","family":"Nakabori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Iino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai","family":"Sakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Kitazawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyasu","family":"Ueda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Murata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Takemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Kiwata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"4095_CR1","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1001\/jamacardio.2022.2718","volume":"7","author":"KM Harris","year":"2022","unstructured":"Harris KM, Nienaber CA, Peterson MD, Woznicki EM, Braverman AC, Trimarchi S, et al. 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