experimental study on age-related compliance mismatch characteristics after thoracic endovascular aortic repair

Long-term complications post-thoracic endovascular aortic repair (TEVAR) may stem from vascular responses to compliance mismatch and patient-specific vessel properties. This in vitro study characterized age-related compliance mismatch characteristics in TEVAR patients. We developed a silicone aortic arch aneurysm model using 3D reconstruction from clinical computed tomography scans and deployed a modular inner branched stent-graft clinically to create an in vitro stent-vessel system. Hemodynamic experiments simulating middle-aged and elderly pressure waveforms assessed vascular wall displacement, blood pressure, and branch perfusion. Results showed a notable compliance mismatch affecting postoperative pressure profiles. Middle-aged subjects exhibited increased systolic, diastolic, and pulse pressures, whereas elderly subjects primarily showed elevated systolic and pulse pressures with minimal diastolic change. TEVAR also increased branch perfusion in both groups. In conclusion, stent implantation has different hemodynamic effects in middle-aged versus elderly patients. Sustained elevated systolic and pulse pressures, especially in middle-aged individuals, may contribute to long-term vascular events like stroke. Vigilant long-term monitoring is crucial, particularly for middle-aged TEVAR recipients.