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Related Experiment Video

Updated: Sep 4, 2025

Porcine Model of Infrarenal Abdominal Aortic Aneurysm
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The Role of Multiple Re-Entry Tears in Type B Aortic Dissection Progression: A Longitudinal Study Using a Controlled

Chlöe Armour1, Baolei Guo2,3, Simone Saitta1,4

  • 1Department of Chemical Engineering, Imperial College London, London, UK.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|July 19, 2022
PubMed
Summary

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Adding re-entry tears in type B aortic dissection (TBAD) can stabilize aortic growth. This study shows that more tears reduce false lumen (FL) pressure, potentially reversing FL expansion and aiding treatment strategies.

Area of Science:

  • Cardiovascular research
  • Medical imaging
  • Computational fluid dynamics

Background:

  • False lumen (FL) expansion in type B aortic dissection (TBAD) is a concern, often linked to re-entry tears.
  • Current treatment guidelines lack specific strategies for managing re-entry tears to control FL expansion.

Purpose of the Study:

  • To investigate the role of re-entry tears in TBAD progression using a swine model.
  • To assess the impact of additional re-entry tears on aortic hemodynamics and FL volume.

Main Methods:

  • Utilized a type B aortic dissection (TBAD) swine model with induced re-entry tears.
  • Acquired Computed Tomography (CT) and 4D Flow Magnetic Resonance Imaging (MRI) data.
  • Performed computational fluid dynamics (CFD) simulations integrating in vivo imaging data.
Keywords:
4D-flow MRIaortic dissectioncomputational hemodynamicsfalse lumen expansionre-entry tear

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Main Results:

  • Increasing re-entry tears from 1 to 2 redistributed blood flow, increasing true lumen (TL) flow from 56% to 78%.
  • Additional tears reduced FL pressure and the pressure difference between lumina.
  • FL volume initially grew by 20% then reduced by 6% after tear creation.

Conclusions:

  • Additional re-entry tears can alter dissection hemodynamics by redistributing flow, reducing FL pressure.
  • This may stabilize aortic growth and lead to reversal of FL expansion.
  • Findings suggest potential for fenestration as a therapeutic approach for managing FL expansion.