Progression from Initial Lesions to Type B Aortic Dissection: A Patient-Specific Study of Computational Fluid Dynamics Models with Follow-up Data

Abstract

Background and

Objective

The natural history of type B aortic intramural hematoma (IMH) is highly heterogeneous. A computational fluid dynamics (CFD) model can be utilized to calculate a range of data pertinent to flow dynamics, including flow rates, blood velocity, pressure, and wall shear stress. This study presents a series of CFD simulations that model the dynamic progression from type B aortic IMH to false lumen formation.

Methods

A 66-year-old male patient presenting with chest and back pain underwent aortic computed tomography angiography (CTA), and a 3D patient-specific model was constructed. To evaluate the hemodynamic environment, the velocity, pressure, time-averaged wall shear stress (TAWSS), and oscillatory shear index (OSI) were calculated.

Results

A modest quantity of slow flow and recirculation flow was observed in the vicinity of the ulcer-like protrusion (ULP). During the formation of the false lumen, low-velocity blood flow entered the false lumen and resulted in vortex flow. ULPs were located in the region with higher TAWSS, and some high OSIs were found on the ULPs.

Conclusion

This preliminary study suggests a potential association between the TAWSS or OSI and progression from type

B aortic IMH to aortic dissection.

Keywords

Type B intramural hematomas / Aortic dissection / Computational fluid dynamics / Time-averaged wall shear force

© The Author(s), under exclusive licence to Huazhong University of Science and Technology 2025

Author Contributions Yue-ying Pan, concept, literature search, manuscript preparation, manuscript editing and revising. Zhi-yue Guan, background research, visualized patient-specific model, data analysis, statistical analysis. Chen-wei Li, experimental studies, data acquisition, data analysis. Han-xiong Guan, design, definition of intellectual content, and manuscript review.

Data Availability The data that support the findings of this study are available from the corresponding author, upon reasonable request.

Declarations

Conflict of Interest The authors declare that there are no conflicts of interest.

Ethical Approval and Consent to Participate This study has been approved by the Ethics Committee of Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, and the patient’s informed consent was waived.

Human Ethics This study is in line with the ethical principles of the Declaration of Helsinki.

Consent for Publication The manuscript has been read and approved by all the authors, and that each author believes that the manuscript represents honest work. All the authors agreed to submit the manuscript to Current Medical Science. And the manuscript has not been and will not be considered for publication elsewhere.

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