{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T02:34:41Z","timestamp":1792722881310,"version":"4.5.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T00:00:00Z","timestamp":1655942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:p>Thoracic endovascular aortic repair (TEVAR) is a commonly performed operation for patients with type B aortic dissection (TBAD). The goal of TEVAR is to cover the proximal entry tear between the true lumen (TL) and the false lumen (FL) with an endograft to induce FL thrombosis, allow for aortic healing, and decrease the risk of aortic aneurysm and rupture. While TEVAR has shown promising outcomes, it can also result in devastating complications including stroke, spinal cord ischemia resulting in paralysis, as well as long-term heart failure, so treatment remains controversial. Similarly, the biomechanical impact of aortic endograft implantation and the hemodynamic impact of endograft design parameters such as length are not well-understood. In this study, a fluid-structure interaction (FSI) computational fluid dynamics (CFD) approach was used based on the immersed boundary and Lattice\u2013Boltzmann method to investigate the association between the endograft length and hemodynamic variables inside the TL and FL. The physiological accuracy of the model was evaluated by comparing simulation results with the true pressure waveform measurements taken during a live TEVAR operation for TBAD. The results demonstrate a non-linear trend towards increased FL flow reversal as the endograft length increases but also increased left ventricular pulsatile workload. These findings suggest a medium-length endograft may be optimal by achieving FL flow reversal and thus FL thrombosis, while minimizing the extra load on the left ventricle. These results also verify that a reduction in heart rate with medical therapy contributes favorably to FL flow reversal.<\/jats:p>","DOI":"10.3389\/fbioe.2022.825015","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T05:47:51Z","timestamp":1655963271000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":33,"title":["Model-Based Fluid-Structure Interaction Approach for Evaluation of Thoracic Endovascular Aortic Repair Endograft Length in Type B Aortic Dissection"],"prefix":"10.3389","volume":"10","author":[{"given":"Arian","family":"Aghilinejad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Magee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niema M.","family":"Pahlevan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"8784","DOI":"10.1038\/s41598-020-65616-7","article-title":"Dynamic Effects of Aortic Arch Stiffening on Pulsatile Energy Transmission to Cerebral Vasculature as a Determinant of Brain-Heart Coupling","volume":"10","author":"Aghilinejad","year":"2020","journal-title":"Sci. Rep."},{"key":"B2","doi-asserted-by":"publisher","first-page":"105003","DOI":"10.1088\/1361-6579\/ac2671","article-title":"Accuracy and Applicability of Non-invasive Evaluation of Aortic Wave Intensity Using Only Pressure Waveforms in Humans","volume":"42","author":"Aghilinejad","year":"","journal-title":"Physiol. Meas."},{"key":"B3","doi-asserted-by":"publisher","first-page":"110852","DOI":"10.1016\/j.jbiomech.2021.110852","article-title":"Effects of Vessel Wall Mechanics on Non-invasive Evaluation of Cardiovascular Intrinsic Frequencies","volume":"129","author":"Aghilinejad","year":"","journal-title":"J. Biomechanics"},{"key":"B4","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12938-015-0032-6","article-title":"Aortic Dissection Simulation Models for Clinical Support: Fluid-Structure Interaction vs. Rigid Wall Models","volume":"14","author":"Alimohammadi","year":"2015","journal-title":"Biomed. Eng. Online"},{"key":"B5","doi-asserted-by":"publisher","first-page":"109130","DOI":"10.1016\/j.jcp.2019.109130","article-title":"A Stable High-Order FC-Based Methodology for Hemodynamic Wave Propagation","volume":"405","author":"Amlani","year":"2020","journal-title":"J. Comput. Phys."},{"key":"B6","volume-title":"Aortic Dissection and Related Syndromes","author":"Baliga","year":"2007"},{"key":"B7","doi-asserted-by":"publisher","first-page":"H1626","DOI":"10.1152\/ajpheart.1994.266.4.h1626","article-title":"Differential Effects of Wave Reflections and Peripheral Resistance on Aortic Blood Pressure: a Model-Based Study","volume":"266","author":"Berger","year":"1994","journal-title":"Am. J. Physiology-Heart Circulatory Physiology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"104263","DOI":"10.1016\/j.jnnfm.2020.104263","article-title":"Effects of Blood Viscoelasticity on Pulsatile Hemodynamics in Arterial Aneurysms","volume":"279","author":"Bilgi","year":"2020","journal-title":"J. Newt. Fluid Mech."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2108","DOI":"10.1016\/j.jvs.2019.06.222","article-title":"Endograft Exclusion of the False Lumen Restores Local Hemodynamics in a Model of Type B Aortic Dissection","volume":"71","author":"Birjiniuk","year":"2020","journal-title":"J. Vasc. Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1007\/s13239-017-0312-3","article-title":"Pulsatile Flow Leads to Intimal Flap Motion and Flow Reversal in an In Vitro Model of Type B Aortic Dissection","volume":"8","author":"Birjiniuk","year":"2017","journal-title":"Cardiovasc Eng. Tech."},{"key":"B11","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jbiomech.2019.06.019","article-title":"Intermediate Fenestrations Reduce Flow Reversal in a Silicone Model of Stanford Type B Aortic Dissection","volume":"93","author":"Birjiniuk","year":"2019","journal-title":"J. biomechanics"},{"key":"B12","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1007\/s10439-014-1075-8","article-title":"Geometric and Flow Features of Type B Aortic Dissection: Initial Findings and Comparison of Medically Treated and Stented Cases","volume":"43","author":"Cheng","year":"2015","journal-title":"Ann. Biomed. Eng."},{"key":"B13","doi-asserted-by":"publisher","first-page":"II237237","DOI":"10.1161\/01.CIR.0000138219.67028.2a","article-title":"Differences in Clinical Presentation, Management, and Outcomes of Acute Type a Aortic Dissection in Patients with and without Previous Cardiac Surgery","volume":"110","author":"Collins","year":"2004","journal-title":"Circulation"},{"key":"B14","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4757-3546-8","volume-title":"Nonlinear Analysis of Thin-Walled Structures: Statics, Dynamics, and Stability","author":"Doyle","year":"2001"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2523","DOI":"10.1016\/s0142-9612(03)00051-6","article-title":"A Novel Bioreactor for the Dynamic Flexural Stimulation of Tissue Engineered Heart Valve Biomaterials","volume":"24","author":"Engelmayr","year":"2003","journal-title":"Biomaterials"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1016\/j.athoracsur.2016.05.020","article-title":"The Impact of Intimal Tear Location and Partial False Lumen Thrombosis in Acute Type B Aortic Dissection","volume":"102","author":"Girish","year":"2016","journal-title":"Ann. Thorac. Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1007\/s10439-008-9527-7","article-title":"Outflow Boundary Conditions for Arterial Networks with Multiple Outlets","volume":"36","author":"Grinberg","year":"2008","journal-title":"Ann. Biomed. Eng."},{"key":"B18","doi-asserted-by":"publisher","first-page":"016701","DOI":"10.1103\/PhysRevE.80.016701","article-title":"Theoretical and Numerical Study of Axisymmetric Lattice Boltzmann Models","volume":"80","author":"Huang","year":"2009","journal-title":"Phys. Rev. E Stat. Nonlin Soft Matter Phys."},{"key":"B19","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1017\/jfm.2017.875","article-title":"Coupling Performance of Tandem Flexible Inverted Flags in a Uniform Flow","volume":"837","author":"Huang","year":"2018","journal-title":"J. Fluid Mech."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2206","DOI":"10.1016\/j.jcp.2007.07.002","article-title":"Simulation of Flexible Filaments in a Uniform Flow by the Immersed Boundary Method","volume":"226","author":"Huang","year":"2007","journal-title":"J. Comput. Phys."},{"key":"B21","doi-asserted-by":"publisher","first-page":"439","DOI":"10.3389\/fbioe.2021.678048","article-title":"The Rheology of the Carotid Sinus: A Path toward Bioinspired Intervention","volume":"9","author":"Iskander","year":"2021","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.jacc.2003.08.054","article-title":"Characterizing the Young Patient with Aortic Dissection: Results from the International Registry of Aortic Dissection (IRAD)","volume":"43","author":"Januzzi","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"e0224390","DOI":"10.1371\/journal.pone.0224390","article-title":"On the Accuracy of Displacement-Based Wave Intensity Analysis: Effect of Vessel Wall Viscoelasticity and Nonlinearity","volume":"14","author":"Kang","year":"2019","journal-title":"PloS one"},{"key":"B24","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.jvs.2012.02.064","article-title":"Longitudinal Computational Fluid Dynamics Study of Aneurysmal Dilatation in a Chronic DeBakey Type III Aortic Dissection","volume":"56","author":"Karmonik","year":"2012","journal-title":"J. Vasc. Surg."},{"key":"B25","doi-asserted-by":"crossref","DOI":"10.1093\/acprof:oso\/9780198528692.001.0001","volume-title":"Spectral\/hp Element Methods for Computational Fluid Dynamics","author":"Karniadakis","year":"2005"},{"key":"B26","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/bf02477850","article-title":"Some Contributions to the Mathematical Biology of Blood Circulation. Reflections of Pressure Waves in the Arterial System","volume":"14","author":"Karreman","year":"1952","journal-title":"Bull. Math. Biophysics"},{"key":"B27","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1016\/s1010-7940(00)00341-9","article-title":"Increased Aortic Compliance Maintains Left Ventricular Performance at Lower Energetic Cost","volume":"17","author":"Kolh","year":"2000","journal-title":"Eur. J. cardio-thoracic Surg."},{"key":"B28","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1002\/fld.997","article-title":"An Axisymmetric Incompressible Lattice BGK Model for Simulation of the Pulsatile Flow in a Circular Pipe","volume":"49","author":"Lee","year":"2005","journal-title":"Int. J. Numer. Meth. Fluids"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1776","DOI":"10.1016\/j.jvs.2019.04.461","article-title":"Anatomic Suitability for \"Off-The-Shelf\" Thoracic Single Side-Branched Endograft in Patients with Type B Aortic Dissection","volume":"70","author":"Magee","year":"2019","journal-title":"J. Vasc. Surg."},{"key":"B30","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.avsg.2021.01.111","article-title":"Hospitalization Cost and In-Hospital Outcomes Following Type B Thoracic Aortic Dissection Repair","volume":"75","author":"Mathlouthi","year":"2021","journal-title":"Ann. Vasc. Surg."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1378\/chest.117.5.1271","article-title":"Epidemiology and Clinicopathology of Aortic Dissection","volume":"117","author":"M\u00e9sz\u00e1ros","year":"2000","journal-title":"Chest"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1161\/hy1201.098298","article-title":"Pulsatile Hemodynamics in Congestive Heart Failure","volume":"38","author":"Mitchell","year":"2001","journal-title":"Hypertension"},{"key":"B33","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1146\/annurev.fluid.37.061903.175743","article-title":"Immersed Boundary Methods","volume":"37","author":"Mittal","year":"2005","journal-title":"Annu. Rev. Fluid Mech."},{"key":"B34","doi-asserted-by":"publisher","first-page":"3115","DOI":"10.1016\/j.apm.2015.09.096","article-title":"Prediction of Thrombus Formation Using Vortical Structures Presentation in Stanford Type B Aortic Dissection: a Preliminary Study Using CFD Approach","volume":"40","author":"Naim","year":"2016","journal-title":"Appl. Math. Model."},{"key":"B35","doi-asserted-by":"publisher","first-page":"H257","DOI":"10.1152\/ajpheart.1999.276.1.h257","article-title":"Structured Tree Outflow Condition for Blood Flow in Larger Systemic Arteries","volume":"276","author":"Olufsen","year":"1999","journal-title":"Am. J. physiology-Heart circulatory physiology"},{"key":"B36","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1016\/j.avsg.2019.04.032","article-title":"Computational Fluid Dynamics Modeling of Hemodynamic Parameters in the Human Diseased Aorta: a Systematic Review","volume":"63","author":"Ong","year":"2020","journal-title":"Ann. Vasc. Surg."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1007\/s10439-011-0246-0","article-title":"A Physiologically Relevant, Simple Outflow Boundary Model for Truncated Vasculature","volume":"39","author":"Pahlevan","year":"2011","journal-title":"Ann. Biomed. Eng."},{"key":"B38","doi-asserted-by":"publisher","first-page":"e23106","DOI":"10.1371\/journal.pone.0023106","article-title":"Aortic Wave Dynamics and its Influence on Left Ventricular Workload","volume":"6","author":"Pahlevan","year":"","journal-title":"PloS one"},{"key":"B39","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1016\/j.jbiomech.2011.05.016","article-title":"Low Pulse Pressure with High Pulsatile External Left Ventricular Power: Influence of Aortic Waves","volume":"44","author":"Pahlevan","year":"","journal-title":"J. biomechanics"},{"key":"B40","doi-asserted-by":"publisher","first-page":"2122","DOI":"10.1016\/j.jbiomech.2013.07.006","article-title":"In-vitro Investigation of a Potential Wave Pumping Effect in Human Aorta","volume":"46","author":"Pahlevan","year":"2013","journal-title":"J. biomechanics"},{"key":"B41","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1007\/s10439-016-1705-4","article-title":"Role of Pulse Pressure and Geometry of Primary Entry Tear in Acute Type B Dissection Propagation","volume":"45","author":"Peelukhana","year":"2017","journal-title":"Ann. Biomed. Eng."},{"key":"B42","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1017\/s0962492902000077","article-title":"The Immersed Boundary Method","volume":"11","author":"Peskin","year":"2002","journal-title":"Acta Numer."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1016\/S0140-6736(96)09372-5","article-title":"Aortic Dissection","volume":"349","author":"Pr\u00eatre","year":"1997","journal-title":"Lancet"},{"key":"B44","doi-asserted-by":"publisher","first-page":"464e465","DOI":"10.1016\/j.jvs.2012.07.008","article-title":"An In Vitro Phantom Study on the Influence of Tear Size and Configuration on the Hemodynamics of the Lumina in Chronic Type B Aortic Dissections","volume":"57","author":"Rudenick","year":"2013","journal-title":"J. Vasc. Surg."},{"key":"B45","doi-asserted-by":"publisher","first-page":"e0124011","DOI":"10.1371\/journal.pone.0124011","article-title":"Assessment of Wall Elasticity Variations on Intraluminal Haemodynamics in Descending Aortic Dissections Using a Lumped-Parameter Model","volume":"10","author":"Rudenick","year":"2015","journal-title":"Plos one"},{"key":"B46","doi-asserted-by":"publisher","first-page":"e0170888","DOI":"10.1371\/journal.pone.0170888","article-title":"False Lumen Flow Patterns and Their Relation with Morphological and Biomechanical Characteristics of Chronic Aortic Dissections. Computational Model Compared with Magnetic Resonance Imaging MeasurementsComputational Model Compared with Magnetic Resonance Imaging Measurements","volume":"12","author":"Rudenick","year":"2017","journal-title":"Plos One"},{"key":"B47","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1007\/s12265-016-9699-8","article-title":"Old Myths, New Concerns: the Long-Term Effects of Ascending Aorta Replacement with Dacron Grafts. Not All that Glitters Is Gold","volume":"9","author":"Spadaccio","year":"2016","journal-title":"J. Cardiovasc. Trans. Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1516","DOI":"10.1046\/j.1365-2168.2000.01566.x","article-title":"Compliance Properties of Conduits Used in Vascular Reconstruction","volume":"87","author":"Tai","year":"2000","journal-title":"Br. J. Surg."},{"key":"B49","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1093\/icvts\/ivr086","article-title":"Long-Term Size Follow-up of Knitted Dacron Grafts (Gelseal\u2122) Used in the Ascending Aorta","volume":"14","author":"Takami","year":"2012","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"B50","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1016\/j.ejvs.2011.08.009","article-title":"A Systematic Review of Mid-Term Outcomes of Thoracic Endovascular Repair (TEVAR) of Chronic Type B Aortic Dissection","volume":"42","author":"Thrumurthy","year":"2011","journal-title":"Eur. J. Vasc. Endovascular Surg."},{"key":"B51","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1056\/nejmoa063232","article-title":"Partial Thrombosis of the False Lumen in Patients with Acute Type B Aortic Dissection","volume":"357","author":"Tsai","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"B52","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1016\/j.jbiomech.2010.12.014","article-title":"Investigation of Hemodynamics in the Development of Dissecting Aneurysm within Patient-Specific Dissecting Aneurismal Aortas Using Computational Fluid Dynamics (CFD) Simulations","volume":"44","author":"Tse","year":"2011","journal-title":"J. biomechanics"},{"key":"B53","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1016\/j.ejvs.2011.08.006","article-title":"Impact of Aortic Grafts on Arterial Pressure: a Computational Fluid Dynamics Study","volume":"42","author":"Vardoulis","year":"2011","journal-title":"Eur. J. Vasc. Endovascular Surg."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.1016\/j.jacc.2009.10.061","article-title":"Prediction of Cardiovascular Events and All-Cause Mortality with Arterial Stiffness: a Systematic Review and Meta-Analysis","volume":"55","author":"Vlachopoulos","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/j.jfluidstructs.2014.12.003","article-title":"An Immersed Boundary-Lattice Boltzmann Flux Solver and its Applications to Fluid-Structure Interaction Problems","volume":"54","author":"Wang","year":"2015","journal-title":"J. Fluids Struct."},{"key":"B56","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1148\/radiology.203.1.9122399","article-title":"The Dissected Aorta: Part I. Early Anatomic Changes in an In Vitro Model","volume":"203","author":"Williams","year":"1997","journal-title":"Radiology"},{"key":"B57","doi-asserted-by":"publisher","first-page":"1963","DOI":"10.1016\/j.jcp.2008.11.019","article-title":"Implicit Velocity Correction-Based Immersed Boundary-Lattice Boltzmann Method and its Applications","volume":"228","author":"Wu","year":"2009","journal-title":"J. Comput. Phys."},{"key":"B58","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.1038\/s41598-018-20603-x","article-title":"Data-driven Modeling of Hemodynamics and its Role on Thrombus Size and Shape in Aortic Dissections","volume":"8","author":"Yazdani","year":"2018","journal-title":"Sci. Rep."},{"key":"B59","doi-asserted-by":"publisher","first-page":"e1005291","DOI":"10.1371\/journal.pcbi.1005291","article-title":"A General Shear-dependent Model for Thrombus Formation","volume":"13","author":"Yazdani","year":"2017","journal-title":"PLoS Comput. Biol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"20210670","DOI":"10.1098\/rsif.2021.0670","article-title":"Simulating Progressive Intramural Damage Leading to Aortic Dissection Using DeepONet: an Operator\u2013Regression Neural Network","volume":"19","author":"Yin","year":"2022","journal-title":"J. R. Soc. Interface"}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2022.825015\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T05:47:55Z","timestamp":1655963275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2022.825015\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,23]]},"references-count":60,"alternative-id":["10.3389\/fbioe.2022.825015"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2022.825015","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,23]]},"article-number":"825015"}}