ArticleJVS-vascular science2026
Changes in local hemodynamic forces associated with arch branched endografts.
Article in JVS-vascular science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Different zone 0 endograft designs have been introduced. This study sought to assess postimplantation hemodynamic changes induced by zone 0 endografts, with varied configuration of side branches, using computational models. Methods: Twenty-nine patients who underwent zone 0 endovascular repair with single-, double-, or triple-branched endografts (n = 7, n = 11, n = 11, respectively), using different configurations of antegrade (A) and retrograde (R) branches, were included. Computational simulations were used to assess postimplantation changes in peak flow rate, systolic blood pressure (SBP) and time-averaged wall shear stress (TAWSS) at the innominate artery (IA), right subclavian artery, right common carotid artery (CCA), left CCA (LCCA), left subclavian artery (LSA), and distal aortic arch, as well as the total displacement force (DF) of the endograft. Results: Regardless of orientation, IA side branch implantation increased the IA peak flow rate across all endograft designs, an effect significant only in single-branched devices (+70%, Conclusions: The hemodynamic stability within the aortic arch improves with a greater number of endograft side branches. Retrograde branch orientation does not significantly affect flow rates or SBP in the supra-aortic vessels. Among the evaluated designs, the triple-retrograde-branched configuration demonstrated the most favorable flow characteristics. Clinical Relevance: Using patient-specific computational fluid dynamics simulations, this study compared the postimplantation local hemodynamic effects of single-, double-, and triple-branched endografts, using different configurations of antegrade and retrograde branches, in complex zone 0 aortic arch repair. Our study suggests two key findings: first, more branching improves hemodynamic stability by steadying blood flow, and second, the specific orientation of retrograde side branches does not affect the supra-aortic arteries. Properly validated, these findings may help to optimize branched endograft selection, ensuring stable hemodynamics for long-term patient success and device durability.
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