Aortic dissection is a life-threatening condition where the inner layer of the aorta, the largest artery in the body, tears. This tear creates a "false channel" inside the aorta, weakening the artery and increasing the risk of rupture. If left untreated, the condition can progress to an aortic aneurysm, where the artery becomes abnormally enlarged, further raising the risk of rupture. Because of the high mortality rate associated with delayed treatment, surgical intervention is often required for the most severe cases.
There are two main types of aortic dissection. Type A affects the ascending aorta and is considered a medical emergency, requiring urgent surgery. Without prompt treatment, the mortality rate for Type A dissections can be as high as 50% within two days and up to 80% within a week. Type B dissections, which affect the aortic arch and descending aorta, are often managed medically and may allow patients to live relatively normal lives. However, they frequently progress to a chronic form, requiring long-term monitoring to prevent complications.
The risk of aortic dissection increases with age, and the primary risk factor is hypertension, or high blood pressure. Other contributing factors include a history of atherosclerosis, existing aortic aneurysms, previous heart surgery, genetic conditions like Marfan syndrome, and the use of substances such as cocaine. Men are more commonly affected than women.
In France, about 5 out of every 100,000 adults are diagnosed with aortic dissection each year. In 2022, 2,726 patients were hospitalized for the condition, with an average age of 67.1 years. Nearly 60% of Type B dissections progress to aneurysmal degeneration, making it difficult to predict which patients will require surgical treatment. Current management relies on anatomical factors like the size of the aorta and the entry point of the dissection, but these measures are not always sufficient to anticipate the progression of chronic dissection.
To address this challenge, the "Aortic Dissection Evaluation Prediction from Digital Twin" (ADEPT) project has been launched. The initiative aims to create a personalized digital twin of the aorta for patients with chronic aortic dissection, allowing doctors to predict the risk of developing an aneurysm. This approach could improve treatment planning and help identify patients who may need surgery sooner.
The ADEPT project will use data from various technologies, including biomechanical analysis of aortic tissue, four-dimensional flow MRI to model blood flow, blood markers that may signal risk, and synthetic models of aortic dissections. These tools will help validate the digital twin models. The project is a collaboration between the University of Bourgogne Europe, the Dijon Bourgogne CHU, and two companies, ennoïa and CASIS. With an estimated total cost of 4.8 million euros, the project has received a grant of 3.6 million euros from the European Union under the FEDER-FSE+ Bourgogne Franche-Comté and Jura Massif 2021-2027 program.
Aortic Dissection Research Aims to Develop Personalized Digital Twin Models for Risk Prediction
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