Hemodynamics of ascending tho¬racic aortic aneurysms:From mechanisms to clinical decision-making
SHI Hao
SHAO Jun
Abstract：Ascending thoracic aortic aneurysm(ATAA)can progress to acute Stanford type A aortic dissection.Current,risk stratification predominantly relies on maximal aortic diameter;however,the frequent occurrence of dissection below established guideline thresholds—known as the"diameter paradox"—highlights the limitations of using a purely anatomical index.In this review,we examine recent advances in hemodynamic studies of ascending thoracic aortic aneurysm from the perspective of geometric remodeling and flow alteration.We elucidate the haemodynamic significance of parameters such as wall shear stress,oscillatory shear index and related parameters,and describe their characteristic patterns in different forms of ascending thoracic aortic aneurysm.Additionally,we discuss studies employing individualized computational fluid dynamics and fluid-structure interaction,which reveal associations between high wall stress zones or low shear stress zones and aneurysm expansion and dissection formation.Finally,we outline how emerging tools such as 4D blood flow MRI and artificial intelligence may facilitate the integration of hemodynamic metrics into operative threshold setting,surgical planning and postoperative surveillance,thereby supporting more individualized management approaches of ATAA.
Keywords：Ascending thoracic aortic aneurysmAortic dissectionHemodynamicsWall shear stressComputational fluid dynamics
Publication Date：2026-01-25
Online Publishing Date：2026-02-04(First online date of this platform, not the publication date of the document)
Pages：6( 71-76 )