[Numerical simulation of coping strategies for the "bird-beak" phenomenon in thoracic endovascular aortic repair].
D, H., S, C., H, Z., & A, Q. (2026). [Numerical simulation of coping strategies for the "bird-beak" phenomenon in thoracic endovascular aortic repair].. Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengx. https://doi.org/10.7507/1001-5515.202511037
D H, S C, H Z, A Q. [Numerical simulation of coping strategies for the "bird-beak" phenomenon in thoracic endovascular aortic repair].. Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengx. 2026; doi: 10.7507/1001-5515.202511037
D H, S C, H Z, et al. [Numerical simulation of coping strategies for the "bird-beak" phenomenon in thoracic endovascular aortic repair].[J]. Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengx. 2026. DOI: 10.7507/1001-5515.202511037.
@article{d2026,
author = {He D and Chen S and Zhang H and Qiao A},
title = {[Numerical simulation of coping strategies for the "bird-beak" phenomenon in thoracic endovascular aortic repair].},
journal = {Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengx},
year = {2026},
doi = {10.7507/1001-5515.202511037},
note = {PMID: 42656107},
}
TY - JOUR AU - He D AU - Chen S AU - Zhang H AU - Qiao A TI - [Numerical simulation of coping strategies for the "bird-beak" phenomenon in thoracic endovascular aortic repair]. T2 - Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengx PY - 2026 DO - 10.7507/1001-5515.202511037 AN - PMID:42656107 ER -
This study aims to explore the effects of different surgical strategies on the "bird-beak" phenomenon during thoracic endovascular aortic repair (TEVAR), so as to provide a theoretical basis for clinical intervention optimization. Three finite element aortic arch models with arch apex angles of 45°, 55°, and 65° were established via finite element simulation. Two stent implantation regions and three gradient stent oversizing ratios of 10%, 20%, and 30% were configured. The bird-beak angle, stent contact area, and vascular wall von Mises stress were quantitatively analyzed to compare the mechanical performance of stent implantation under different parameter combinations. Our results revealed a negative correlation between aortic arch angle and the threshold oversizing ratio required for bird-beak elimination. For 45° small angle aortic arches, 30% oversizing was necessary to resolve the bird-beak effect, whereas merely 20% oversizing sufficed for 55° and 65° larger angle arches. Nevertheless, excessive oversizing of 30% induced stent ring kinking and prolapse, reduced stent vessel apposition area, substantially elevated aortic wall stress, and raised the risk of vascular injury. Furthermore, landing zone 2 implantation was associated with a significantly higher risk of bird-beak formation compared with landing zone 3. In conclusion, stents with >20% oversizing are recommended for patients with 45° small angle aortic arches, with close attention paid to preventing stent deformation. For 55° and 65° aortic arches, 20% oversizing is sufficient to mitigate complications related to bird-beak. These findings offer theoretical support for operative planning and complication reduction in clinical TEVAR practice. 本研究旨在探讨不同术式对胸主动脉腔内修复术中“鸟嘴”现象的影响，为临床应对策略提供理论依据。本研究通过有限元仿真，构建45°、55°、65°三组主动脉弓有限元模型，设置2种支架植入区域与10%、20%、30%梯度支架放大率，通过检测鸟嘴角度、支架接触面积及血管壁von Mises应力，对比不同参数的植入效果差异。研究发现，主动脉弓角度与消除鸟嘴现象的支架放大率阈值呈负相关。45°小角度主动脉需30%放大率方可消除鸟嘴，55°、65°大角度主动脉仅需20%放大率即可达标。但30%高放大率会造成支架环扭结、翘起，降低支架贴合面积，同时明显升高血管壁应力，增加血管损伤风险。另外，2区植入的鸟嘴发生风险显著高于3区。综上，临床对45°小角度主动脉，可选用20%以上放大率支架，并重点防控支架形变风险；55°、65°主动脉采用20%放大率支架即可有效规避鸟嘴问题。研究结论可为临床制定手术方案、降低相关并发症提供理论支撑。.