Liver transplantation remains the primary treatment for end-stage liver disease, however, a shortage of suitable grafts persists. Factors contributing to this imbalance include insufficient organ quality, which exhibit higher complication rates, exacerbated by static cold storage. Normothermic Machine Perfusion (NMP) is proposed as an alternative, offering dynamic preservation, and quality assessment. This study introduces magnetic resonance elastography (MRE), to evaluate changes of viscoelastic properties of the liver after NMP for quality assessment.

Lamellar and dispersed fibrous collagen networks are organized and maintained via endogenous crosslinks along the superior-inferior and nasal-temporal directions in the stromal regions of corneal tissues. Collagen organization contributes to corneal transparency, tissue integrity, and the surface topography. Ultrastructural changes to the lamellar arrangement of collagen occur in diseases, such as keratoconus and ectasia post refractive surgery, resulting in impaired biomechanical properties, changes to the surface curvature, and irregular astigmatism. Collagen crosslinking with UV-A/riboflavin is used clinically to increase the structural integrity and halt corneal thinning; however it can cause complications in certain cases. Earlier studies suggest that crosslinking mediated by advanced glycation end products (AGE), associated with ageing, may increase corneal stiffness and prevent corneal thinning. The specific links between corneal properties and microstructural network features are however not well established. We used collagenase and non-enzymatic crosslinking using methylglyoxal (MGO) to investigate the effects of collagen content, organization, and crosslinking densities in an ex-vivo goat cornea model. We estimated the collagen contents using a biochemical assay, performed uniaxial mechanical tests, and used histology to quantify the underlying fiber tortuosity in untreated (control) and collagenase/MGO treated groups. We fit the experimental stress-strain data using an exponential strain energy function (SEF) that uses a generalized structure tensor to describe collagen fiber organization in tissues. Our results show that fiber tortuosity increased with collagenase treatment time. AGE-mediated non-enzymatic crosslinking using MGO caused a dramatic increase in the elastic modulus of tissues without significant changes to the fiber tortuosity or overall collagen content. Finally, we obtained scaling relationships linking tissue modulus to collagen volume fraction that may be useful clinically. Changes in fiber tortuosity with collagenase treatment suggest that collagen fiber organization and composition play a key role in regulating mechanobiological properties of the cornea.

Shear load transfer is crucial for the redistribution of internal tendon loads and to prevent excessive local stress that can lead to severe damage and injury. To better understand this transfer mechanism, it is important to know the stress state. The aim of the present study is to investigate the normal and shear stresses in tendons sheared with the shear force applied parallel to the fascicles and collagen fibers. A key novelty of the paper is the simultaneous measurement of normal and shear forces, as well as the amount of shear of tendon samples under simple shear. For the sake of simplicity, a more straightforward model is employed to describe the normal and shear behavior of tendons. Expressions were simultaneously fitted to the measured normal and shear stresses. The results reveal that the shear behavior did not exhibit any evidence of strain-stiffening, because the shear stress was approximately proportional to the amount of shear. However, compressive and tensile normal stresses, or positive and negative Poynting effects, respectively, were observed in different samples. Each tendon specimen was sheared along the orientation of the longitudinal fascicles and collagen fibers, which were maintained by random fiber networks associated with connective tissue and cross-link structures. Compressive normal stress indicates that random fiber networks did not influence the behavior or were not significant in a certain range, whereas random fiber networks contribution was more pronounced in the case of tensile normal stress. These findings suggest that the effects of random fiber networks, which can manifest over different length scales, play an important role in the state of normal stress in tendons under simple shear. Understanding how random fiber networks influence tendon mechanics could lead to better treatments for tendon injuries and help design biomimetic materials.

Inappropriate rotational and feed speed of the rotary nickel-titanium (Ni-Ti) file can cause damage to the root canal wall. Consequently, it is essential to examine the relationships among filing parameters, file stress, and axial force to establish a dependable foundation for the selection of parameters.

Universal talus implant has emerged as an innovative solution for talus bone collapse, aiming to retain the clinical benefits of custom total talus replacement while addressing its logistical drawbacks. A subject-specific combined musculoskeletal-finite element (MSK-FE) modeling framework was developed to evaluate two universal talus implant designs during dynamic gait: a purely cobalt chromium (CoCr) implant, and an implant coated with polycarbonate-urethane (PCU), both compared to the native talus. To do so, a MSK simulation of the stance phase of gait was conducted to estimate joint kinematics and joint reaction forces in the ankle complex, with a subsequent dynamic FE simulation performed to assess contact characteristics in terms of contact area and pressure, in cartilages surrounding the talus/implant. The FE model was built directly from the bone geometries of the MSK model to ensure consistency across the study. Results showed that the PCU-coated implant more closely replicated native biomechanics, while the CoCr implant produced consistently higher pressures and smaller contact regions. Normalized RMSE across gait confirmed lower deviation from the native case for the PCU-implant in most joints. These findings highlight the potential of PCU coated implants in improving contact mechanics in articular cartilage as well as the potential of the universal implant topology. This is the first study to dynamically evaluate intra-articular behaviour in all joints surrounding the talus bone during gait, and particularly by analysing the performance of universal talus implants, demonstrating the utility of a MSK-FE approach and offering valuable insights into implant performance under physiological conditions, informing future implant design.

Additive manufacturing (AM) has been used to process complex one-of-a-kind patient-specific implants, along with on-demand manufacturing with innovative geometries. AM parts are more susceptible to fatigue failure due to inherent porosities than conventionally processed parts. This study investigates the high-cycle rotating bending fatigue behavior of laser powder bed fusion (LPBF) processed Ti6Al4V parts in as-processed and hot isostatically pressed (HIPed) conditions, and compares them to commercially available wrought Ti6Al4V. Ti6Al4V is widely used in orthopedic and dental implants due to its high strength-to-weight ratio, good biocompatibility, and excellent corrosion resistance. To understand the fatigue performance of Ti6Al4V parts, a custom cell was designed to fully immerse the fatigue samples in Dulbecco's Modified Eagle Medium (DMEM) for the duration of the test. The fatigue strength was normalized to the compressive yield strength, and it was found that as-processed samples had the greatest compressive strength but approximately half the relative endurance limit (10 cycles) when compared to wrought and HIPed samples. This inferior fatigue performance of as-processed samples was attributed to porosity defects inherent to the AMed parts. However, it was found through fractography and energy-dispersive spectroscopy (EDS) analyses that these internal defects dominated the fatigue crack initiation in as-processed samples, making DMEM immersion have a minimal effect. The wrought and HIPed samples were susceptible to corrosion fatigue, showing a reduction in endurance limit of 9 % and 6 % in relative strength, respectively. This study highlights the need for in situ corrosion fatigue evaluation of additively manufactured load-bearing implants.

This computational study aimed to evaluate the bone-implant interaction of dental implants made from materials with varying Young's moduli under various conditions of bone quality. A subject-specific numerical workflow was developed by integrating boundary conditions obtained from a musculoskeletal multibody simulation (MMBS) into a finite element (FE) analysis of the mandible bone. Implants made from commercially pure titanium (cp-Ti), zirconia ceramic (ZrO), low-stiffness β-titanium alloy (β-Ti), and poly-ether-ether-ketone (PEEK) were evaluated during a clenching scenario. A systematic analysis was performed using statistical modeling to examine ten variations in bone quality, including cortical thickness and homogeneous bone stiffness. Additionally, two CT-based subject-specific comparisons were carried out using mandibles with distinctly different bone qualities. Implants made from materials with lower stiffness resulted in increased peri-implant strain and stress levels. In the statistical analysis, these effects were not significant when accounting for inter-individual variability of the bone qualities (p > 0.05). Cortical bone stiffness strongly correlated with peri-implant bone stress (r = 0.96 ± 0.01), while trabecular bone stiffness correlated with maximum (r = 0.71 ± 0.01) and minimum (r = -0.83 ± 0.02) principal strain in the bone. In the subject-specific analysis, stress and strain in the peri-implant bone increased for the low-quality bone and were significant for a PEEK-based implant (p < 0.001). Within the restrictions of the simplified numerical models and limited generalizability of the present findings, materials with lower stiffness may reduce peri-implant stress shielding but simultaneously increase stress at the bone-implant interface. However, their overall effect was not statistically significant when inter-individual variation in bone quality were considered.

Traditional helmet foam pads have limited energy absorption for blunt impacts, unable to meet protective needs in complex ballistic scenarios such as fragments and bullets. Auxetic (negative Poisson's ratio) materials have been tested for helmet pads, but existing studies focus mainly on low-velocity impact protection. Thus, optimizing auxetic pad structures for high-velocity impacts is essential. In this study, lightweight expanded thermoplastic polyurethane (TPU-LW) was used as the base material, with 3D printing to fabricate pad samples. First, TPU-LW's material constitutive model was established via uniaxial tensile tests. Simulations later revealed a key issue: a single auxetic pad caused excessive skull peak stress. To solve this, an innovative "auxetic + foam" composite pad was designed, verified by 9 mm pistol bullet and 1.1 g fragment tests. The composite pad outperformed single auxetic and foam pads in key head blunt impact indicators. Simulations showed that under high-velocity fragment impact, the helmet's maximum backface deformation (BFD) dropped to 14.50 mm, and skull peak stress was 22.7 % lower than the foam pad. Experiments indicated that under 714 m/s fragment impact, peak head pressure was only 25 kPa - far below the foam pad's 165 kPa. This study fills the biomechanical data gap of auxetic TPU-LW in ballistic protection. The proposed composite structure provides a theoretical basis and technical solution for upgrading helmet pads from "single-material" to "composite energy-absorbing structure," applicable to various protective helmet research and development.

In recent years, percutaneous procedures are gradually replacing open heart surgery for the treatment of tricuspid valve pathological conditions deploying prosthetic devices (i.e., stent-graft) within the proximal portion of the cava veins. Nevertheless, since there is no comprehensive mechanical characterization of the venous district, the devices exploited in these procedures are very similar to the ones exploited in aortic treatment, involving possible critical periprocedural complications. According to the international standards adopted for the design of novel vascular devices, this study presents an experimental set-up to investigate the biomechanics of fifteen porcine cava veins with the development of a semi-automatic protocol for compliance testing. During the tests, 2D echo images of the vessel lumen are acquired for different steps within a pressure range of 5-20 mmHg. The acquired pressure-diameter curves of the samples are then derived by a polynomial function, furthermore, the compliance values are obtained using the corresponding equations as well. The results demonstrate that the cava vein exhibits a hyperelastic behavior, with a nonlinear relationship between pressure and diameter. At low pressures, the veins demonstrate high compliance and reduced stiffness (11.54 ± 4.76 kPa). On the contrary, when pressures exceed the normal physiological range (i.e., greater than 10 mmHg), the veins become stiffer (294.70 ± 233.00 kPa). The developed set-up, based on an ex-vivo porcine model, proved to be a robust tool for the assessment of vein biomechanics and for preclinical benchmarking of novel venous endovascular devices.

Improper cage placement during spinal interbody fusion surgeries could lead to numerous post-operative complications. Biomechanical factors of such improper placement may result in loss of lumbar lordosis, foraminal stenosis, subsidence, and altered stress distribution to the tissues adjacent to the cage.

This study aimed (1) to develop and characterize 3D-printed hydrogel-based scaffolds composed of sodium alginate and gelatin containing amorphous magnesium phosphate (AMP), and (2) to evaluate the scaffolds' biological response with alveolar bone-derived mesenchymal stem cells (aBMSCs). Hydrogel inks were prepared with sodium alginate, gelatin, calcium chloride, and varying AMP contents (0 %, 5 %, and 10 %). The scaffolds were fabricated using an extrusion-based 3D bioprinter. First, the formulated hydrogel-based inks were characterized for rheological behavior and printability. After printing, the scaffolds were assessed for morphology, chemical composition, mechanical properties, and swelling/degradation profiles. For in vitro cell-scaffold interaction, scaffolds were seeded with aBMSCs and analyzed for cell viability, matrix mineralization, and osteogenic gene expression via RT-qPCR. Statistical analysis was performed with ANOVA/Sidak or Tukey tests, with confidence intervals (α = 5 %). Rheological analysis showed that all inks exhibited shear-thinning behavior, more pronounced in AMP-containing formulations. Filament drop tests and printability assessments demonstrated filament uniformity and structural fidelity in AMP-containing inks. Morphological analysis revealed well-defined scaffold architecture with regular edges, and SEM confirmed smooth surface morphology with uniform AMP distribution. FTIR spectra displayed characteristic phosphate and polymer bands, while EDS confirmed the presence of magnesium and phosphorus in AMP-containing scaffolds. The swelling behavior increased over 24 h, and all 3D-printed scaffolds fully degraded within 35 days. All formulations supported increased cell viability over time (p ≤ 0.0092). AMP-containing scaffolds enhanced mineralized matrix deposition under osteogenic stimulation (p < 0.0001), particularly in the 10 % AMP group, and promoted upregulation of osteogenic genes (COL1A1, ALPL, and RUNX2). Clinical significance: This study demonstrated that incorporating AMP into alginate-based hydrogels combines printability, biodegradability, and osteoconductive properties. Previous AMP-containing biomaterials lacked optimization for material extrusion-based 3D printing or the synergistic combination with a gelatin-alginate network. This strategy represents an advance in the field, offering a potential biomaterial ink for the fabrication of personalized scaffolds for craniofacial bone regeneration, enabling synergistic modulation of rheology and early osteogenic stimulation.

Tumor consistency influences meningioma handling during surgery, but systematic biomechanical classifications are lacking. In this prospective study, 129 tumor slices from 20 meningiomas underwent amplitude-sweep oscillatory rheometry (1-100% strain, 1 Hz) to characterize storage modulus (G'), loss modulus (G″), damping (tan δ), yield strain, and strain stiffening. Curves were normalized, embedded by principal component analysis, and subjected to unsupervised clustering. Three reproducible viscoelastic phenotypes were identified (Cluster A: 29%, B: 61%, C: 9%) that differed significantly across baseline stiffness, stiffening slope, yield strain, and damping (all q < 1 × 10). Cluster C, defined by high stiffness and elevated dissipation, was strongly associated with intraoperative hard grading (OR 82.8, 95% CI 11.0-623.2, p < 0.0001). Tumor-level stiffness index correlated with overall consistency (ρ = 0.48, p = 0.033), and the hard-phenotype fraction tracked both maximum (ρ = 0.54, p = 0.013) and minimum consistency (ρ = 0.53, p = 0.017). Entropy-based heterogeneity did not predict surgical consistency range. Clustering robustness was confirmed by bootstrap (ARI 0.81) and leave-one-tumor-out analysis (ARI 0.79). These findings suggest a quantitative biomechanical classification of meningiomas directly linked to operative handling.

This study aimed to evaluate the effects of a translucency-enhancing liquid (TEL) and high-speed sintering (HS) on the mechanical behavior, with a focus on the survival rates and fracture forces of anterior zirconia crowns with different yttria contents.

Determining the biomechanical properties of skeletal muscle in-vivo is challenging due to structural anisotropy. In this study, we developed combined diffusion tensor imaging (DTI) and magnetic resonance elastography (MRE) to quantify direction-dependent biophysical properties of the lower leg muscles and their changes during passive plantarflexion (PF) and dorsiflexion (DF). Thirteen male volunteers were studied using DTI-MRE. Anisotropic shear-wave-speeds parallel (c) and perpendicular (c) to the fiber orientation were reconstructed by aligning MRE vector wave fields to the principal fiber axis with rotation angles obtained from DTI tractography. Isotropic c was also calculated without rotation for comparison. Fractional anisotropy (FA), radial (RD) and axial diffusivity (AD) were obtained from DTI. c was higher than c in tibialis anterior (TibA), whereas the opposite was observed in posterior soleus (SolP). From PF to DF, c and c changed significantly in all muscles: TibA (-15 ± 11 %, -15 ± 13 %), SolP (8 ± 12 %, 9 ± 11 %), and gastrocnemius medialis (GasM) (11 ± 15 %, 21 ± 14 %), respectively (all p < 0.05). c was only sensitive in TibA (-13 ± 7 %) and GasM (4 ± 11 %), both p < 0.05. For DTI, from PF to DF, FA and RD changed significantly in TibA (-20 ± 12 %, 10 ± 7 %), SolP (26 ± 12 %, -6±6 %), and GasM (19 ± 12 %, -5±7 %), respectively (all p < 0.001). AD only changed in SolP (3 ± 5 %, p < 0.01). In conclusion, anisotropic MRE was more sensitive to ankle positions in lower leg muscles than isotropic MRE and revealed biomechanical differences between muscle types. In the future, DTI-MRE with anisotropic parameter reconstruction could be used for the detection of subtle structural changes in muscle diseases.

Sudden dynamic loading scenarios can often lead to undesirable mechanical responses in certain systems. However, in nature it is seen that certain species are found to have biological sutures in regions of their body where they are accustomed to dynamic loading. This has inspired the implementation of sutural geometries into originally flat regular hexagonal honeycomb tessellation interfaces comprised of harder hexagonal phases joined by a thinner, softer phase. These sutures are characterized by their tooth tip angle, wavelength, and amplitude and are studied to determine their influences the mechanical responses of the samples under dynamic indentation loading. Interestingly, suture tessellations can achieve negative Poisson's ratio in a certain design space. Both auxetic and non-auxetic designs under dynamic indentation loadings have been investigated via finite element (FE) simulations. Dynamic explicit FE simulations are conducted, using elasto-perfectly-plastic models for both hard and soft phases. The introduction of suture geometry leads to less plastic deformation in the composites, better dispersion of impact energy, and a lower peak load compared to the original flat tessellation counterparts. Additionally, results show that for 2D sutural tessellations, auxeticity enhances energy dissipation efficiency under dynamic indentation load.

Each year, approximately 30 million Cesarean deliveries are performed globally, involving surgical incisions through the abdomen and uterus, followed by suturing of the uterus and skin after childbirth. The presence of prior uterine incisions disrupts native uterine tissue properties and increases the risk of complications in subsequent pregnancies. Thus, tissue repair scaffolds for this application must promote regeneration and restore the mechanical strength required to withstand the uterine loading. Despite the importance of mechanical considerations in regeneration, the fracture mechanics and energetics of scaffolds for this application have not been systematically characterized. In this work, we developed a novel gelatin methacryloyl-gelatin fiber composite platform by embedding electrospun gelatin fibers of different nanoscale diameters within a hydrogel matrix. Mechanical testing of fiber mats and composites under uniaxial tension and Mode III tearing revealed that fiber diameter strongly influences stiffness, extensibility, and fracture resistance. Further, compared to fiber mats alone, fiber-reinforced composites demonstrate enhanced energy dissipation while retaining physiologically relevant hydration, thereby mimicking native tissue. These results establish critical structure-function relationships in gelatin-based composite systems and highlights their potential as load-bearing scaffolds for uterine tissue repair.

Accurate detection of tumor boundaries is critical for the success of oncologic surgical intervention. Traditionally, palpation can handover important information for tumor localization based on the tissue mechanical properties, but in Minimally Invasive Surgery no direct access to the tumor for palpation is feasible. For providing a technical analogy, this feasibility-level study focusses on the simplified problem of detection of an inclusion within a homogeneous silicon phantom. We hypothesized that existence of a relatively stiffer inclusion within an elastomer tissue phantom changes vibroacoustic signatures under forced vibration conditions. In comparison with previous studies, in this work the measurement probe was static, and the short-time (1 s) data package analysis targeted at nearly real-time inclusion detection. The inclusion detection problem was cast into a binary classification of the short-time acquired vibroacoustic signals. The method involves a wavelet-based multilayer perceptron neural network (MLP) that is trained in a supervised manner. A micro-electro-mechanical system (MEMS) sensor proximally attached to a solid probe was used to measure the vibroacoustic signals. Phantoms of simulated healthy tissue with stiffer tumor model inclusions were used for experiments and data collection. From the 120 overall number of experiments, 15 % were used as test data to evaluate the performance. The results show inclusion detection F1 score of 75 %, and 77.8 % accuracy related to the confusion matrix, reflecting the model performance on previously unseen data. Performance of the classifier was discussed in terms of various binary classification metrics, and compared with another established classifier, support vector machine (SVM). While the results support the hypothesis of this proof-of-concept study, extensions like improving the electronic system and refining the method with more experiments on biological tissues remain as the future work.

Although the finite element method (FEM) is a valuable computational tool for analyzing factors that influence bone-screw fixation strength in osteosynthesis, it faces challenges in capturing the effects of screw insertion prior to pullout simulation due to mesh distortion and element erosion. To address these limitations, this study introduces an orthopedic computational model based on the Smoothed Particle Galerkin (SPG) method, offering an enhanced approach for simulating bone-screw interactions. The Smoothed Particle Galerkin (SPG) method is an advanced mesh-free numerical technique capable of simulating large deformations and material removal while avoiding common mesh-related issues in FEM. In this study, the SPG method is used to model the Sawbones material during screw insertion and pullout. A bond-failure model is incorporated into the SPG framework to represent material removal, employing two failure criteria: the critical effective shear strain and the critical effective plastic strain. This modeling approach allows for accurate reproduction of thread formation in the bone during screw insertion, capturing the appropriate contact geometry and residual stress conditions for subsequent pullout simulations. To validate the accuracy of the proposed simulation model, experimental tests were performed using Sawbones specimens composed of grade 15 PCF polyurethane foam, serving as an analog for human cancellous bone. The nonlinear material properties of the Sawbones were characterized following ASTM D1621 for compression and ASTM D1623 for tension. Parameters of the bond-failure model were calibrated through a combined screw insertion and pullout simulation using a non-fluted screw with a pilot hole. For the predictive analysis, three test cases were modeled, each combining different pilot-hole sizes and screw types, with and without cutting flutes. The proposed simulation model successfully reproduces thread formation, a feature that is difficult to capture using conventional FEM approaches. The results demonstrate that screw insertion induces residual stress, which strongly affects the pullout force. In addition, both pilot-hole size and screw design are shown to significantly influence residual stress and pullout performance. Comparison of pullout forces between experiments and simulations across three prediction cases, showing average errors of +4.0 %, -11.8 %, and -6.0 %, indicates that the proposed model is a promising tool for analyzing bone-screw fixation strength while accounting for the screw insertion effect, a capability not available in existing simulation frameworks.

The infrapatellar fat pad (IFP), an adipose tissue located in the anterior knee joint, is hypothesized to absorb shocks and aid in joint lubrication. We investigated the consequences of IFP removal on joint friction and damping in an in vitro animal model. The hindlimbs of female New Zealand white rabbits were dissected to retain the knee ligaments, joint capsule, and patellar retinaculum. Knees were mounted in a pendulum with the knee joint serving as the fulcrum while keeping the quadriceps tendon unloaded to assess joint friction and damping in each knee for three conditions: Control, Sham, and no IFP (IFP-R). Friction and damping were assessed under a 15N tibio-femoral joint load (40 % of body weight) at three flexion angles (50°, 100°, and 130°), and gyroscopic data were recorded to obtain the time decay of amplitude. Two models, a linear friction and an exponential decay friction model, were fit to the amplitude decay over time. The linear model provided Stanton's joint boundary friction coefficient (μ); the exponential decay model provided an exponential decay friction (μ) and a viscous damping (c) coefficient. When compared across all angles of testing, IFP removal decreased μ by 6 % (p = 0.0057) vs Controls (μ = 0.0217 vs 0.0230); IFP removal decreased c by 9 % (p < 0.001) vs Controls (c = 0.00262 vs 0.00239 kgm/s) and by 6 % vs Sham (p = 0.017, c = 0.00255 vs 0.00239 kgm/s). IFP removal did not affect μ (p = 0.12).

The aortic elasticity plays a vital role in buffering pulsatile blood flow, propelling blood to distal organs and the heart, and reducing cardiac workload. Aortic repair with a stent-graft can reduce this elasticity and hinder the aorta's ability to effectively perform its function. Conventional stent-grafts are associated with increased arterial stiffness, elevated pulse wave velocity (PWV), and adverse hemodynamic changes. This is largely driven by stiffness mismatch between the stent-graft and the native aortic wall, which alters mechanical compliance and hemodynamic response. This study evaluates a novel compliant nanofiber stent-graft (NF-SG) developed to closely mimic native aortic mechanics. Using a bench-top physiological flow circuit, we assessed the hemodynamic impacts of stent-graft stiffness and length on arterial parameters, including PWV, pulse pressure (PP), and distensibility in vitro, and compared these effects with conventional stent-grafts. Stent-graft stiffness significantly affected PWV, PP, and distensibility. Conventional stent-grafts showed 14 %-52 % increase in PWV depending on stent-graft length (p < 0.001), 5 %-32 % increase in PP, and 82 % reduction in mid-graft distensibility. In contrast, NF-SGs maintained PWV and PP near baseline levels with marginal effect of the stent-graft length. Distensibility in the mid-graft was reduced by 13 %-20 %, depending on the stent-graft length. The NF-SG's superior compliance and reduced hemodynamic perturbation were attributed to its mechanically optimized fabric and skeleton design. These findings underscore the clinical potential of the compliant stent-grafts to significantly mitigate long-term cardiovascular complications and preserve aortic functionality post-intervention.