Figure 5.

The potential role of biomechanics in the aortic dissection process. a) Formation of the intimal tear is initiated by the longitudinal wall stresses which exceed the longitudinal wall strength of the aortic wall. b) Loading conditions on the wall tissue are changed by the formation of an intimal tear, creating significant shearing between the intimal and adventitial layers. c) When the shearing stresses exceed the strength of the medial layer, a false lumen with subsequent blood flow into this lumen was created. d) In the scenario where no intimal tear exists, the pressure gradient created by drastically different fluid dynamics in the false and true lumen would facilitate the propagation of dissection.