An experimental investigation of the impact of thoracic endovascular aortic repair on longitudinal strain

Abstract

This experimental study showed that TEVAR acutely stiffens the aorta in the longitudinal direction and thereby induces a strain mismatch, while tensile testing confirmed that longitudinal aortic fragments are most prone to rupture, particularly close to the arch. Such an acute strain mismatch of potentially vulnerable tissue might play a role in TEVAR-related complications, including retrograde dissection and aneurysm formation. The finding that TEVAR stiffens the aorta longitudinally may also shed light on systemic complications following TEVAR, such as hypertension and cardiac remodelling. These observations may imply the need for further improvement of stent-graft designs.