Progressive Failure Research Articles

Retransplantation in Living Donor Liver Transplantation.

The need for retransplantation after living donor liver transplantation can occur early, mainly because of technical difficulties such as hepatic artery thrombosis or as a result of early allograft dysfunction as a symptom of small-for-size syndrome. Patients with autoimmune diseases may develop progressive graft failure from recurrent disease. The ethics of retransplantation can be complicated by the cause of the initial liver disease, which may be self-inflicted or the outcome of malignancy. This is especially true in countries without the availability of deceased donors for salvage, and a second living donor would be needed. Nevertheless, patients who experience early or late graft failure should be considered for retransplant if they are deemed acceptable candidates. When a living donor is required for retransplant, the equipoise between donor risk and autonomy and recipient outcome should be considered.

Portopulmonary hypertension: peculiarities of diagnosis and treatment

Portopulmonary hypertension is defined as the development of pulmonary hypertension secondary to portal one. Its exact prevalence is difficult to determine due to the lack of routine screening in patients with portal hypertension. Hemodynamic changes associated with portal hypertension, including the hyperdynamic state, portosystemic shunts, and splanchnic vasodilation, cause significant disturbances in the pulmonary vasculature and play a key role in the pathogenesis of the disease. Without treatment, portopulmonary hypertension leads to progressive right ventricular failure with a poor prognosis. Although Doppler echocardiography is the best initial screening tool for symptomatic patients and candidates for liver transplant, right heart catheterization remains the gold standard for disease diagnosis. Treatment of patients with portopulmonary hypertension is aimed at improving cardiac function, reducing pulmonary vascular resistance, and optimizing functional capacity. Pulmonary hypertension-specific therapy, which includes prostacyclin and its receptor agonists, endothelin receptor antagonists, phosphodiesterase inhibitors, and guanylate cyclase stimulators, plays a key role in the treatment of patients with portopulmonary hypertension. Small uncontrolled and recent single randomized controlled trials have reported promising results of vasodilator therapy in terms of clinical and hemodynamic improvement in patients, allowing certain patients to undergo liver transplantation. This review discusses the epidemiology, approach to diagnosis and treatment of patients with portopulmonary hypertension. We used MEDLINE database on the PubMed platform and the Cochrane library to search for literature sources using the keywords: portopulmonary hypertension, portal hypertension, pulmonary hypertension, liver cirrhosis, pulmonary complications.

NOVEL INTEGRATED IMAGING PARAMETERS FOR RISK STRATIFICATION OF ATRIAL FIBRILLATION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY

Abstract Background Atrial fibrillation (AF) impacts prognosis of hypertrophic cardiomyopathy (HCM) by promoting progressive heart failure (HF) and increasing risk of stroke. Over the past years, several indexes and methods to predict AF among HCM patients have been proposed. However, they are limited by a lack of accuracy. Aims of our study was to evaluate the role of new echocardiographic parameters in predicting new onset of AF and to validate them by cardiac magnetic resonance (CMR). Methods and Results We analyzed clinical and imaging data of 141 HCM patients in sinus rhythm who underwent first evaluation at our center (51.2 ± 17.3 years, mean follow up 5.3 ± 3 years). Main parameters analyzed were left atrium (LA) end–diastolic volume (LAV min), end–systolic volume (LAVmax), LA ejection fraction (LAEF), left atrioventricular coupling index (LACI), and LA diameter (LAD). LACI was defined by the LAVmin divided by the LV end–diastolic volume (LVEDV); this parameter was assessed in previous studies as a good detector of early atrial remodeling and impaired LV compliance. 35 patients developed new–onset AF (after a mean period of 4 ± 3.2 years). At the baseline evaluation, LACI, LAD, and LAVmin showed to be significantly greater in patients who developed AF compared to patients who did not. At CMR, LACI >44% accurately predicted new–onset AF (sensitivity 85%, specificity 70%; AUC 0.81). LACI by ETT showed similar accuracy (AUC 0.75) and was superior to that shown by LAD (AUC 0.71) (Figure 1). Patients who did not develop AF had significantly higher LAEF at ETT (49.3 ± 11% vs 37 ± 9.6%; p < 0.0001). CMR analysis confirmed this result. LAEF >43% was a good predictor of AF free survival (log rank<0.001). Conversely, at a multivariate analysis, LAFE <43% by ETT was independently associated with AF occurrence (OR 4.5, 95% CI 1.4–13.7) (Figure 2). 11 patients experienced death or heart transplant (HTx). Higher values of LACI and LAVmin and lower values of LAEF were found to be associated the composite outcome of death or HTx. LACI>60% predicted the composite of death or HTx with good accuracy (AUC 0.74) (Figure 3). Conclusions LACI and LAEF showed to improve accuracy in predicting the new onset of AF in HCM patients without severe LA dilatation (LAD>45mm). Higher LACI and Lower LAEF (namely <43%) identify patients at higher risk of new onset AF, and, therefore, worthy of a more strict follow–up.

De Novo Elastin Assembly Alleviates Development of Supravalvular Aortic Stenosis.

A series of incurable cardiovascular disorders arise due to improper formation of elastin during development. Supravalvular aortic stenosis (SVAS), resulting from a haploinsufficiency of ELN, is caused by improper stress sensing by medial vascular smooth muscle cells, leading to progressive luminal occlusion and heart failure. SVAS remains incurable, as current therapies do not address the root issue of defective elastin. We use SVAS here as a model of vascular proliferative disease using both human induced pluripotent stem cell-derived vascular smooth muscle cells and developmental Eln± mouse models to establish de novo elastin assembly as a new therapeutic intervention. We demonstrate mitigation of vascular proliferative abnormalities following de novo extracellular elastin assembly through the addition of the polyphenol epigallocatechin gallate to SVAS human induced pluripotent stem cell-derived vascular smooth muscle cells and in utero to Eln± mice. We demonstrate de novo elastin deposition normalizes SVAS human induced pluripotent stem cell-derived vascular smooth muscle cell hyperproliferation and rescues hypertension and aortic mechanics in Eln± mice, providing critical preclinical findings for the future application of epigallocatechin gallate treatment in humans.

Effect of crack density on crack initiation and damage for high confining pressure using wave velocities

The study of progressive failure of reservoir rocks is very important for the stability analysis of ultra-deep boreholes. The progressive failure can be characterized by the crack initiation stress (CI), crack damage stress (CD) and peak stress (Peak), which is controlled by the evolution of cracks in rock and is significantly affected by confining pressure. To explore the effect of high confining pressure and initial crack on the progressive failure, the initial crack density of 121 sedimentary rock samples was characterized by acoustic waves, and the progressive failure under different confining pressures was analyzed. Experiments show that the ratios of CI to Peak (CI/Peak) and CD to Peak (CD/Peak) increase significantly with confining pressure, which is agreement with the existing conclusion from low confining pressure (0–52 MPa), but those decrease for high confining pressure (68–85 MPa) above critical point of sandstone. The CI/Peak and CD/Peak decrease with increase of initial crack density, which is sensitive to confining pressure but independent of rock type and grain size. The CD of sandstone is pertinent to the friction coefficient of cracks. These results laid a foundation for analyzing the evolution mechanism of wellbore damage and predicting the timing of wellbore instability in ultra-deep wells.

Palliative care in kidney transplant recipients with graft failure.

Kidney transplantation is the best renal replacement therapy for patients with end stage kidney disease. It provides longer patient survival and better quality of life than dialysis. The clinical course after kidney transplantation could be complex and variable. Patients may develop various complications or even kidney graft failure. Symptom burden related to uraemia in patients with graft failure, and the side-effects of immunosuppression, cause psychological distress and adversely affect the quality of life of patients. Treatment decisions in patients with graft failure can be challenging to patients and their caregivers. Renal palliative care is an emerging field, but its adoption remains relatively low among kidney transplant recipients with progressive graft failure. In this context, timely consideration and referral for palliative care can improve symptom burden, reduce stress in patients and their caregivers, and facilitate treatment goal setting and advanced care planning. Common barriers to bring palliative care to suitable patients include: (I) misconception in patients, caregivers and healthcare providers that palliative care means abandonment of life sustaining treatment; (II) over-optimistic prognostic assessment and over-aggressive management approach; (III) insufficient awareness and training in palliative care of healthcare professionals; (IV) inadequate access to and insufficient resources in palliative care. Enhanced training and awareness, and further studies, would be needed to optimize the decision process and delineate the benefit of palliative care, and to guide evidencebased practice in the transplant population.

Investigations of the Progressive Damage and Failure Behaviors of Thermally Treated Granite Under the Coupling Action of Biaxial Stress Constraint and High Strain Rate

Investigations of the Progressive Damage and Failure Behaviors of Thermally Treated Granite Under the Coupling Action of Biaxial Stress Constraint and High Strain Rate

A comparative study of progressive failure of granite and marble rock bridges under direct shearing

Shear failure of rock bridges is an important process in geological phenomena, including landslides and earthquakes. However, the progressive failure of natural rock bridges has not yet been fully understood. In this work, we carried out direct shearing experiments on both granite and marble rock bridges, and applied acoustic emission (AE) monitoring throughout the experiments. With the mechanical curves and the evolution of AE activity (including AE energy rate and b value), the failure of rock bridges can be divided into three pre-failure phases and one ultimate failure phases. We analyzed the effects of normal stress and lithology on the pre-failure phases. We noted that with the increasing of normal stress, the length of stable cracking phase decreases and the length of unstable cracking phase slightly increases, except for marble rock bridges at high normal stress, which maintains a great proportion of stable cracking phase that possibly results from the great off-fault damage. Increasing normal stress also suppresses the dilation of granite rock bridges, but has a different effect on marble rock bridges, which also suggests the effect of lithology on failure modes.

Investigating the failure mechanism of X-shaped non-persistent joints under uniaxial loading: Experimental and numerical analysis

In this paper, rock samples containing non-persistent cracks of ‘‘X’’- shape were prepared and experimentally studied under uniaxial compression. Then, the numerical simulations of these tests were established using dynamic finite element software (LS-DYNA). Various joint configurations are assumed and their lengths are considered to change from the center of “X” in different rock specimens. The cracks propagation patterns, the failure processes, and energy absorptions during the tests are studied. The gypsum samples’ dimensions were 10 × 10 × 5 cm and one “X” shaped non-persistent crack was provided inside each specimen. The tensile strength of gypsum samples was 1 MPa. The notch's lengths are similar in some three cases while the length of one wing of the crossest joint varied in two other cases. In two residual cases, the length of the two wings of the crossest joint was varied. The opening of the crack was 1 mm. Angel between the notch trajectories was 90°. The model was subjected to an applied axial load rate of 0.05 mm/min. Results show that the failure mechanism of specimens was affected by notch length. The larger notch has a dominant effect on the breakage mode and failure strength. Newborn tensile cracks originated at the notch tip and propagated parallel to the loading axis to merge with the model boundary. Both the crack initiation stress and breakage stress were decreased by increasing the notch length. The absorbed energy has a minimum value when two large notches with a length of 6 cm exist in the model while it has a maximum value when notch lengths are equal to 2 cm. The increase in notch length resulted in a decrease in the difference between strains associated with crack initiation stress and final stress, indicating progressive breakage. Whereas the difference between strains associated with crack initiation stress and final stress was increased by decreasing the notch length, therefore delay failure occurred after crack initiation in the model. The results obtained from both laboratory experiments and numerical simulations show good agreement in the failure progression.

Progressive Failure Mechanism of Shield Tunnel Face in Complex Urban Geological Environment

The construction of multiple tunnels across inland rivers has had a significant influence on the improvement of the transportation infrastructure. The technology for constructing tunnels is progressing towards the development of larger cross-sections, longer distances, and the ability to withstand high hydraulic pressure in complex hydrogeological conditions, including high-permeability strata. In order to ensure the face stability of shield tunnels under high hydraulic pressure that crosses a fault fracture zone, it is necessary to study the progressive failure mechanism of shield tunnel faces induced by high hydraulic pressure seepage. This paper employs finite element numerical simulation software to methodically examine the variation in the characteristics of the water seepage field, limiting support force, and face stability failure mode of shield tunnels passing through fault fracture zones with high hydraulic pressure under varying fault fracture width zones. The results show that the formation hydraulic gradient will progressively widen when the tunnel face is located within the undisturbed rock mass and is advanced towards the area of fault fracture. This will raise the likelihood of instability in the shield tunnel and progressively raise the limiting support force on the tunnel face. Moreover, as the tunnel face nears the region of fault fracture within the undisturbed rock mass, the damage range increases gradually. In addition, due to the increase in seepage force, the angle between the failure area and the horizontal plane becomes more and more gentle. On the contrary, as the tunnel’s face moves closer to the undisturbed rock mass from the region of the fault fracture, the damage range gradually decreases, and the dip angle between the damage area and the horizontal plane becomes steeper and steeper due to the decreasing seepage force in the process. The study findings presented in this work are highly significant, both theoretically and practically, for the design and management of safety.

Selection of long-term shear strength parameters for strain softening geosynthetic interfaces (2023 IGS Rowe Lecture)

The behavior of strain-softening geosynthetic interfaces that can lead to progressive failures in lined containment facilities has been a source of confusion in slope stability evaluations for over 30 years. The paper presents fifteen mechanisms that can potentially induce displacements along strain-softening interfaces, along with measures that can be considered to reduce strain-softening displacement. New quantifications of shear strength variability that can be caused by manufacturing, installation, and construction practices are introduced. Guidance and recommendations are given that are applicable to numerical continuum as well as limit-equilibrium approaches to assist in selecting appropriate geosynthetic shear strength parameters for containment facilities that have strain-softening interfaces. While most of the paper focuses on deep-seated critical interfaces for high normal stress bottom liners, low normal stress veneer covers are also addressed.

Out of hospital sudden cardiac arrest as a prognostic factor for in-hospital mortality in patients admitted with cardiogenic shock

Abstract Funding Acknowledgements None. Background The mortality in cardiogenic shock (CS) is still high despite new comprehensive therapies. Cardiac arrest (CA) frequently complicates CS which can have an unfavourable effect on the course after admission. Purpose The study aimed to analyse the clinical characteristics and prognosis of patients admitted with CS after out-of-hospital cardiac arrest (OHCA) compared to the group without OHCA. Methods The studied group consisted of a total of 80 patients with an average age of 62 ± 13 years (81 % male) admitted to tertiary hospital with CS in the period 2021-2022. The severity of the shock according to the Society for Cardiac Angiography and Interventions (SCAI) SHOCK classification among the whole population was from C to E: 7 (9%), 38 (48%), and 35 (43%), respectively. The cohort was divided into 2 subgroups: the OHCA group consisted of 23 individuals (29%) and the without OHCA (non-OHCA group) consisted of 57 individuals. Results The groups did not differ in terms of demographic parameters and comorbidities. There were no differences in baseline heart rate 95 [50;114] vs. 91 [77;105] beats per minute and mean artery pressure 75 [70;97] vs. 82 [70;97] mmHg for OHCA vs. non-OHCA, respectively, all p> 0.05. Patients from OHCA group had higher baseline creatinine level 1.65 [1.35;1.88] vs. 1.37 [1.08; 1.65] mg/dL, p=0.019, white blood cell count 12 [9;16] vs. 17 [12;23] × 109/L, p=0.015 and lower pH from blood gas analysis 7.0 [6.9;7.2] vs. 7.3 [7.2;7.4], p<0.001). In the OHCA group, 90% of cases of CS were caused by acute coronary syndrome (ACS), while in the group without OHCA, 76% were due to ACS and 20 % due to the progression of chronic heart failure, p=0.032. Mechanical Circulatory Support (MCS) was used in almost every patient (98% non-OHCA vs. 95% OHCA), however, the OHCA group was more often treated with V-A ECMO 14 (64%) vs. 16 (28%) in the non-OHCA, p=0.004. The overall number of in-hospital deaths was 57 (71%). The OHCA group had significantly higher in-hospital mortality 22 (96%) compared to the non-OHCA patients 35 (61%), p=0.002. Conclusion Patients experiencing CS complicated by OHCA have more often ischaemic ethology of shock, have a greater degree of organ damage and a lower pH in blood gas analysis at admission, and have extremely high in-hospital mortality rates when compared with patients facing CS but without prior OHCA, which underscores the urgent need for improved prevention methods, interventions, and public awareness.

Comparative effectiveness of second line oral antidiabetic treatments among people with type 2 diabetes mellitus: emulation of a target trial using routinely collected health data

ObjectiveTo compare the effectiveness of three commonly prescribed oral antidiabetic drugs added to metformin for people with type 2 diabetes mellitus requiring second line treatment in routine clinical practice.DesignCohort study...

New Insights into IGF-1 Signaling in the Heart.

Insulin-like growth factor (IGF)-1 signaling has multiple physiological roles in cellular growth, metabolism, and aging. Myocardial hypertrophy, cell death, senescence, fibrosis, and electrical remodeling are hallmarks of various heart disease and contributes to the progression of heart failure. This review highlights the critical role of IGF-1 and its cognate receptor in cardiac hypertrophy, aging and remodeling.

Acoustic emission signatures for quantifying damage patterns in half grouted sleeve connection under tensile load

The half-grouted sleeve connection (HGSC) have been widely used as connection tools for prefabricated concrete (PC) buildings. It is crucial to maintain the safety and stability of the nodes and detecting internal defects in the grouting sleeve for the safety of the entire structure. Therefore, understanding the mechanical behavior and damage mechanism of HGSC is essential for the design and construction of PC. Currently, there are few on-site techniques applicable for monitoring the damage progress. The acoustic emission (AE) as a passive method shows great potential to characterize the damage in the HGSC. Therefore, in this paper, we propose to use AE to quantify the damage of the HGSC with defects under the tensile load. The artificial defects were introduced into HGSC with different defective rates. The monotonic tensile load was applied to each HGSC sample with a loading rate of 0.33 mm/s and tested to the failure. In this process, the AE signals were collected by AE transducers. For the classification and prediction of damage signals, we utilized a machine learning framework tailored for HGSC. This framework integrates unsupervised k-means++ cluster analysis and supervised K-Nearest Neighbors (K-NN) for damage classification and prediction. The experimental results showed that four AE signal clusters can be defined during the progress of tensile failure:(i) microcrack expansion;(ii) the friction signals of rebar and high-strength grouts; (iii)the generation of microcracks; (iv) plastic deformation of rebar. The corresponding AE signatures were identified. The K-NN model trained on the training data provides a high accuracy in predicting different class of defects. It was concluded that the proposed machine learning framework is a promising and powerful tool for realizing the on-site damage detection and prediction for HGSC.

Peculiarities of the ST-segment elevation myocardial infarction morphogenesis after mechanical restoration of epicardial blood flow without ECG signs of reperfusion

The aim of the study was to investigate the peculiarities of STEMI morphogenesis after mechanical restoration of epicardial blood flow without ECG signs of reperfusion. The autopsy data of 44 patients with STEMI who died at different times after PCI performed within the first 12 hours (27 cases), or 12–24 hours (17 cases), without ECG signs of reperfusion after the intervention, were analyzed. The comparison group consisted of 85 deceased without reperfusion therapy (RT). Histological examination of the myocardium was performed at following time: within 12 hours, at 13–24 hours, 2–4 days, 5–8 days, 9–15 and 16–22 days. The most common cause of death was acute left ventricular failure (ALVF) both in the group of blood flow restoration without ECG signs of reperfusion, and in the group without RT: 85 % and 79 %, respectively. In each of the two groups the number of deaths occurred in the first 12 hours exceeded one third, half of the patients died in the subsequent 12 hours, two thirds of the deaths occurred within further 2–3 days. The rates of risk factors: older age, anterior and recurrent myocardial infarction, three-vessel lesion of the coronary artery, and a large infarction area were similar in the two groups. From the first hours after PCI, the infarction zone was characterized by hemorrhagic imbibition, numerous injuries of the microcirculatory bed, by the signs of blood flow restoration in damaged vessels appeared from days 2–4, early manifestations of repair from days 5–7. In the MI group without PCI, the hemorrhagic demarcation started on days from 3–4, coagulation necrosis prevailed in the microvascular bed, signs of repair appeared at a later date. Multiple spasms and thromboses in the microvasculature may have been a response to a blood pressure drop that accompanies an acute decrease in the left ventricle contractile function caused by a large infarction area and/or unresolved complications arising during the interventions per se. This mechanism explains the rapid progression of left ventricular failure, the most common cause of death after the interventions with achieving the epicardial blood flow without ECG signs of reperfusion. The revealed microcirculation disorders reflect the absence of myocardial reperfusion, which is more prognostically significant than the restoration of epicardial blood flow.

Acute Coronary Syndrome (ACS) with ST-Segment Elevation Revealing Cardiac Amyloidosis: A Case Report and Literature Review

Cardiac Amyloidosis (CA) is an infiltrative cardiomyopathy characterized by the accumulation of fibrillar proteins in the myocardium. The deposition of these proteins disrupts the structure and function of the heart, leading to thickened walls, increased myocardial mass, diastolic dysfunction, and altered myocardial contraction, ultimately causing progressive heart failure. We report the case of a 65-year-old patient, S.L., admitted to our service with Acute Coronary Syndrome (ACS) with a posterior extended ST-segment elevation, Killip class I, semi-recent. She is hypertensive and diabetic; she previously underwent surgery for chronic constrictive pericarditis, presumed to be of tuberculous origin, and was treated accordingly. The echocardiogram revealed a hypokinetic left ventricle (LV), predominantly affecting the inferior, inferoseptal, and apical walls. The left and right atria were not dilated, and both ventricles were of normal size. Coronary angiography showed no significant anomalies. Cardiac MRI supported a diagnosis of localized amyloidosis. Through this case, we explore the various clinical forms of CA, referencing existing literature.

Detecting and managing the patient with chronic kidney disease in primary care: A review of the latest guidelines.

Chronic kidney disease (CKD) is a major global health problem, affecting about 9.5% of the population and 850 million people worldwide. In primary care, most CKD is caused by diabetes and/or hypertension, but a substantial proportion of cases may have alternative causes. During the early stages, CKD is asymptomatic, and many people are unaware that they are living with the disease. Despite the lack of symptoms, CKD is associated with elevated risks of cardiovascular disease, progressive kidney disease, kidney failure and premature mortality. Risk reduction strategies are effective and cost-effective but require early diagnosis through testing of the estimated glomerular filtration rate and albuminuria in high-risk populations. Once diagnosed, the treatment of CKD centres around lifestyle interventions, blood pressure and glycaemic control, and preventative treatments for cardiovascular disease and kidney disease progression. Most patients with CKD should be managed with statins, renin-angiotensin-aldosterone system inhibitors and sodium-glucose cotransporter-2 inhibitors. Additional treatment options to reduce cardiorenal risk are available in patients with diabetes, including glucagon-like peptide-1 receptor agonists and non-steroidal mineralocorticoid receptor antagonists. The Kidney Failure Risk Equation is a new tool that can support the identification of patients at high risk of progressive kidney disease and kidney failure and can be used to guide referrals to nephrology. This review summarizes the latest guidance relevant to managing adults with, or at risk of, CKD and provides practical advice for managing patients with CKD in primary care.

Damage evolution of tunnel lining under creep action considering interlayer effect in gently inclined layered surrounding rock

The anisotropy and creep characteristics of layered sandstone mudstone with different structural inclinations have a significant impact on the safety of tunnel construction and operation. we conducted research of the layered sand-mudstone of the Yunding Tunnel on the Dazhou-Chengdu line, based on the mechanical response mechanism of layered surrounding rock and employing a numerical coupling analysis method, established a creep damage mechanical model of layered rock to study the progressive failure characteristics of layered rock and the failure mechanism of tunnel lining. The results indicate that:(1) The response mechanism of layered rock mechanics based on the delamination effect can well reflect the progressive fracture of the layered rock and distinguish the failure mode of layered rock; (2) The established layered rock mechanics contact model can effectively characterize the anisotropic macroscopic mechanical properties of layered sand-mudstone in biaxial test and triaxial creep test; (3) The fracture characteristics of the layered surrounding rock matrix change significantly with the change of the dip angle of the structural plane, the cracks mainly appear in the direction perpendicular to the structural plane. And it can be determined that the critical angle of sliding failure of layered sand mudstone is α1 = 28.77°, α2 = 65.47° (4) The damage evolution of lining can be divided into four states: 1. elastic state 2. injury working state 3. ultimate bearing state 4. damage state. With the increase of the dip angle of the structural plane, the time for the lining to enter the ultimate bearing state is gradually delayed, and the delayed rate shows the characteristics of ’slower-faster-slower’. This research achievement can provide a certain foundation for the analysis of the failure mode and the failure mechanism of tunnel lining.

The effect of lateral thrust on the progressive slope failure under excavation and rainfall conditions

AbstractLarge landslides can involve the multiple failures of regional slopes. To understand the effect of lateral thrust caused by the failure of one slope on its surroundings, the failures of two adjacent highway slopes in Guangdong Province, China, were investigated in detail. The interactive failure processes and landslide morphological characteristics of the two slopes were first analyzed based on the on-site investigation. Then, a plane mechanical model of a large-scale slope was established to evaluate the significant influence of the lateral thrust generated by the west slope acting on the east excavated slope. Furthermore, the extrusion effect of the west slope was modelled under the alternate excavation disturbance and rainfall by transferring the thrust forces onto the interface elements, and the induced failure mechanism and instability mode of the east slope under lateral thrust were reproduced numerically. The results show that the compression-shear failure occurred at the middle and rear slope bodies because of the lateral thrust, which led to the formation of a thrust landslide and the final instability of the east slope.