Framework for fluid-structure interaction analysis of aortic coarctation resulting from proximal protusion of thoracic aortic stent graft into the arch

Abstract

Thoracic aortic stent grafts (TASG) are commonly used to repair aortic anomalies or diseases in a minimally-invasive fashion. One complication of TASG is collapse, whereby blood is unable to completely flow through the graft as intended. Most TASG collapses occur in the setting of endovascular repair of traumatic thoracic aortic transection, where a typically smaller diameter aorta of pediatric patients is repaired with a relatively larger diameter endograft designed to treat aneurysmal disease. It is hypothesized that the poor apposition of the leading edge of the proximal stent graft to the lesser curvature of the aortic arch can result increased hemodynamic force at the leading side of the graft can reach sufficient magnitude to cause collapse and gradual occlusion of the tubular graft. The incidence rates of stent graft collapse in endovascular aortic transection repairs have been reported to range from 0.03% to 10%.