{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T10:57:46Z","timestamp":1765277866520,"version":"3.46.0"},"posted":{"date-parts":[[2025,12,2]]},"group-title":"Cardiovascular Medicine","reference-count":41,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  Type B aortic dissection (TBAD) is a serious, potentially life-threatening condition which occurs when a tear develops in the inner lining (intimal layer) of the descending aorta, causing the layers of the aortic wall to separate (dissect) and creating true and false lumens. TBAD can be classified into complicated and uncomplicated types based on the presence of complications (e.g., rupture or malperfusion). For complicated TBAD, the standard treatment is thoracic endovascular aortic repair (TEVAR) with a stent graft. Uncomplicated TBAD can be managed with optimal medical therapy (OMT). Predicting growth and aneurysmal progression of uncomplicated TBAD is clinically important for timing of intervention during OMT. In this study, we extended our previously developed finite element (FE)-based tissue growth framework and applied it to predict the precise geometry and diameter growth of TBAD. Specifically, the unified-fiber-distribution (UFD) model was applied to describe aortic wall mechanics, and a novel centerline-based algorithm was developed to determine the local material coordinates of aortic tissues. A linear kinematic growth law related to local wall stress was used for tissue growth. Patient-specific aortic geometries from three serial computed tomography (CT) scans were obtained for seven patients with TBAD. Using the first two CT images and each patient\u2019s blood pressure, inverse FE analysis was performed to obtain patient-specific growth parameters. These parameters were then used to simulate forward growth and predict geometry at the third time point. Predicted aortic geometries and dimensions matched well with\n                  <jats:italic>in vivo<\/jats:italic>\n                  measurements: across all patients the maximum diameter error was below 3.5% and the mean diameter error below 4%. Such accurate patient-specific growth forecasts demonstrate the potential of this computational framework to support clinical decision-making in uncomplicated TBAD.\n                <\/jats:p>","DOI":"10.64898\/2025.11.24.25339532","type":"posted-content","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T10:54:53Z","timestamp":1765277693000},"source":"Crossref","is-referenced-by-count":0,"title":["Growth Prediction of Type B Aortic Dissections Using Wall-Stress-Driven Finite Element Simulation Based on the Unified-Fiber-Distribution (UFD) Model"],"prefix":"10.64898","author":[{"given":"Xue","family":"Liang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc-Philipp H.","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minliang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah L.","family":"Cebull","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunny","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Naeem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John N.","family":"Oshinski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Elefteriades","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Rudolph L.","family":"Gleason","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley G.","family":"Leshnower","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"issue":"206","key":"2025120902543729000_2025.11.24.25339532v1.1","doi-asserted-by":"crossref","first-page":"20230281","DOI":"10.1098\/rsif.2023.0281","article-title":"Aneurysmal growth in type-B aortic dissection: assessing the impact of patient-specific inlet conditions on key haemodynamic indices","volume":"20","year":"2023","journal-title":"Journal of the Royal Society Interface"},{"issue":"1","key":"2025120902543729000_2025.11.24.25339532v1.2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1053\/j.optechstcvs.2018.07.001","article-title":"TEVAR for acute complicated type B aortic dissection","volume":"23","year":"2018","journal-title":"Operative Techniques in Thoracic and Cardiovascular Surgery"},{"key":"2025120902543729000_2025.11.24.25339532v1.3","doi-asserted-by":"crossref","first-page":"108041","DOI":"10.1016\/j.compbiomed.2024.108041","article-title":"The role of anatomic shape features in the prognosis of uncomplicated type B aortic dissection initially treated with optimal medical therapy","volume":"170","year":"2024","journal-title":"Computers in Biology and Medicine"},{"key":"2025120902543729000_2025.11.24.25339532v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.12.038"},{"issue":"2","key":"2025120902543729000_2025.11.24.25339532v1.5","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.athoracsur.2018.08.012","article-title":"Predictors of failure of medical management in uncomplicated type B aortic dissection","volume":"107","year":"2019","journal-title":"The Annals of thoracic surgery"},{"issue":"1","key":"2025120902543729000_2025.11.24.25339532v1.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21037\/acs-2021-taes-25","article-title":"Thoracic endovascular repair of chronic type B aortic dissection: a systematic review","volume":"11","year":"2022","journal-title":"Annals of Cardiothoracic Surgery"},{"issue":"4","key":"2025120902543729000_2025.11.24.25339532v1.7","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1093\/ejcts\/ezx292","article-title":"How does descending aorta geometry change when it dissects?","volume":"53","year":"2018","journal-title":"European Journal of Cardio-Thoracic Surgery"},{"key":"2025120902543729000_2025.11.24.25339532v1.8","doi-asserted-by":"crossref","unstructured":"E. 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