Computational Fluid Dynamics Modeling of Proximal Landing Zones for Thoracic Endovascular Aortic Repair in the Bovine Arch Variant

Massimiliano M. Marrocco-Trischitta, Rodrigo M. Romarowski, Moad Alaidroos, Francesco Sturla, Mattia Glauber, Giovanni Nano

Research output: Contribution to journalArticlepeer-review


Background: To assess the endograft displacement forces (DF), which quantify the forces exerted by the pulsatile blood flow on the vessel wall and transmitted on the terminal fixation site of the endograft after its deployment in proximal landing zones (PLZs) of the bovine aortic arch variant. Methods: Thirty healthy aortic computed tomographic angiographies of subjects with bovine arch configuration (10 per type of arch, I–III) were selected for the purpose of the study. A 3-dimensional model of the aortic arch lumen was reconstructed. Computational fluid dynamics modeling was then used to compute DF magnitude and orientation (i.e., x, y, and z axes) in PLZs of each case. DF values were normalized to the corresponding aortic wall area to estimate equivalent surface traction (EST). Results: DF were highest in zone 0, consistently with the greater surface area. DF in zone 3 were much greater than in zone 2 because of a 3-fold greater upward component (z axis) (P < 0.001), being therefore mainly oriented orthogonally to the aortic blood flow and to the vessel longitudinal axis in that zone. EST progressively increased from zone 0 toward more distal PLZs, with EST in zone 3 being much greater than that in zone 2 (P < 0.001). The same pattern was observed after stratification by type of arch. Conclusions: The bovine arch is associated with a consistent fluid dynamic pattern, which identifies in zone 3 an unfavorable biomechanical environment for endograft deployment.

Original languageEnglish
Pages (from-to)413-417
Number of pages5
JournalAnnals of Vascular Surgery
Publication statusPublished - Nov 2020

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine


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