主动脉夹层腔内隔绝术后，部分病例可在腔内移植物远、近端再发破裂，导致患者猝死，其发生发展的生物力学机制亟需研究。我们前期研究表明：腔内移植物与主动脉管壁的不匹配和再发破裂密切相关。据此我们提出：是否可以通过研究这种形态学上的不匹配导致再发破裂的生物力学机制，建立腔内移植物机械力学-血液动力学-管壁应力学的再发破裂风险模型，从而为腔内移植物的改进与应用提供理论依据？拟开展以下研究：①通过分析临床资料，深入筛选再发破裂相关危险因素，为生物力学分析提供关键靶点；②通过计算机血液动力学、移植物与管壁相互作用的机械力学分析，研究管壁的应力分布，阐明再发破裂的力学条件；③将力学影响，以不同构型的腔内移植物，应用于夹层动物模型，进行生物力学分析，建立再发破裂风险模型，并验证改进的腔内移植物的生物力学效能。本研究将有助于阐明再发破裂的生物力学机制，为提高主动脉夹层腔内治疗水平提供实验依据和新的研究思路。

Endovascular stent-graft repair was introduced as an important alternative to conventional open surgery for the treatment of descending aortic dissections. But studies reported various complications caused by stent-grafts, among which, stent graft-induced new entry is not a rare complication and with high mortality. Despite of its importance, investigation on this aspect has been least carried out and the underlying mechanisms are still unknown. .As an alien objective, the endograft is much stiffer than the host arterial tissues. Moreover, when it is deployed, it can induce high mechanical stress concentrations over the contact region. Therefore the hypothesis of this study is the high stress concentration induced by the endograft and the local hymodynamic effects response for the onset of new entry. .This study will be conducted in three aspects: First, retrospectively analyze the clinical data to sieve out the targets for following biomechanical analysis; Second, accurately calculate and depict the stress concentration over the contact region on cases of new entry, by computational hemodynamic simulation and the mechanical analyses of the interaction between the endograft and the aortic wall. These analyses will explain the associations between morphological features and the subsequent clinical event; Third, according to above mechanical analyses, modify the configuration of the stent-graft and use it on the animal model of Stanford type B aortic dissection. Then, test and analyze the biomechanical effects on the aorta as a whole, as well as on the local artery tissue of different contact regions. At last, integrating these results into a hazard regression model will help to find out the histologic evidence of the mechanical and hymodynamic effects, and to identify the best stent-graft configuration for respective aortic dissection..This study will provide important in-sight on the mechanism of stent graft-induced new entry, and it will be essential for optimizing the stent-graft design to preferably match the aortic dissection configuration. As biomechanical rationales of endovascular treatment of aortic dissection, the outcomes of this study may have great clinical potential.