{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:59:39Z","timestamp":1780898379417,"version":"3.54.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"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:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Despite the widespread use of fenestrated thoracic endovascular aortic repair (TEVAR), clinical outcomes exhibit considerable heterogeneity whose underlying hemodynamic mechanisms remain poorly understood. This study aimed to establish a patient-specific computational framework integrating postoperative computed tomography angiography (CTA) and computational fluid dynamics (CFD) to quantitatively evaluate morpho-hemodynamic alterations after fenestrated TEVAR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Six aortic dissection patients undergoing TEVAR with left subclavian artery (LSA) fenestration (three\n                      <jats:italic>in situ<\/jats:italic>\n                      , three\n                      <jats:italic>in vitro<\/jats:italic>\n                      ) were included. Patient-specific 3D aortic geometries were reconstructed from postoperative CTA. High-fidelity CFD simulations were performed to analyze flow distribution, velocity, time-averaged wall shear stress (TAWSS), and oscillatory shear index (OSI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Computational analysis revealed that the brachiocephalic trunk was the least affected vessel following TEVAR (median AR\n                      <jats:sub>BT<\/jats:sub>\n                      0.80, IQR 0.74\u20130.89). Notable abnormalities included one case of severe LSA stenosis (AR\n                      <jats:sub>LSA<\/jats:sub>\n                      = 5.25, V\n                      <jats:sub>LSA, systole<\/jats:sub>\n                      = 1.15\u00a0m\/s), and one instance of mild stent-induced proximal LCCA compromise (AR\n                      <jats:sub>LCCA<\/jats:sub>\n                      = 1.27, V\n                      <jats:sub>LCCA, systole<\/jats:sub>\n                      = 1.06\u00a0m\/s), both demonstrating TAWSS elevation at affected segments. Additionally, one patient exhibited inadequate endovascular recovery in the descending aorta, which received only 42.83% of the total cardiac output. The remaining patients showed no significant hemodynamic abnormalities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This pilot study establishes a patient-specific computational framework that integrates CTA with CFD to decipher post-intervention morpho-hemodynamic alterations. By quantitatively linking stent-induced geometric changes to adverse hemodynamic phenotypes, the demonstrated methodology explores a mechanistic approach for understanding post-surgical outcome disparities, thereby establishing a computational tool for postoperative evaluation. The clinical utility and predictive value of this tool, however, await validation in larger, prospective cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1797348","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:33:05Z","timestamp":1780896785000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A patient-specific CTA-CFD framework deciphers hemodynamic heterogeneity after fenestrated TEVAR: a pilot study"],"prefix":"10.3389","volume":"14","author":[{"given":"Baoyou","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiac and Thoracic Vascular Surgery, The First People\u2019s Hospital of Jiashan County","place":["Jiaxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Simulation Science and Technology, Shaanxi Xinmai Medical Technology Co., Ltd.","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenpu","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Aeronautics and Astronautics, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1016\/j.asej.2014.05.010","article-title":"Carreau fluid model for blood flow through a tapered artery with a stenosis","volume":"5","author":"Akbar","year":"2014","journal-title":"Ain Shams Eng. 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