LAUSR

TEVAR is widespread in clinical practice for treating aortic disease but it has relevant systemic complications, such as increase of the cardiac work load due to post TEVAR aortic stiffening, and local issues such as re-entry tears due to the tissue damage caused by endograft interaction. {The present study aims to elucidate these aortic biomechanical mechanisms by coupling ex-vivo and in silico analysis. By ex-vivo tests, the pulse wave velocity before and after TEVAR is measured. Uni-axial tensile tests are perfomred to measure regiocal mechanical response of tissue samples, supplied as input data for the in-silico analysis. Numerical analysis is finally performed to compute the wall stress induced by the stent-graft deployment and the arterial pressurization. The ex-vivo results highlight an increase of baseline PWV by a mean 0.78 m/s or 12% after TEVAR with a 100 mm stent-graft (P<0.013). In the \textit{in-silico} analysis, the average von Mises stress in the landing zone increases of about 15% and 20% using respectively stent-graft with radial oversizing of 10% and 20%. This work shows the effectiveness of integrated framework to analyse the biomechanical mechanisms post TEVAR. Moreover, the obtained results quantify the effect of prosthesis selection on the stiffening of the aorta after TEVAR and on the local increase of the aortic wall stress that is proportional to the stent-graft oversizing This article is protected by copyright. All rights reserved.