Aortic Compliance Following EVAR and the Influence of Different Endografts:Determination Using Dynamic MRA
| Autor: | Bart E. Muhs, Frans L. Moll, Lambertus W. Bartels, Joost A. van Herwaarden, Hence J.M. Verhagen, Koen L. Vincken, Arno Teutelink, Joffrey van Prehn |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Endovascular aneurysm repair Magnetic resonance angiography Aortic aneurysm Aneurysm Blood vessel prosthesis Angioplasty medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Aorta Aged medicine.diagnostic_test business.industry Middle Aged medicine.disease Abdominal aortic aneurysm Blood Vessel Prosthesis Prosthesis Failure Pulsatile Flow cardiovascular system Feasibility Studies Stents Surgery Aortic stiffness Radiology Cardiology and Cardiovascular Medicine Nuclear medicine business Magnetic Resonance Angiography Aortic Aneurysm Abdominal Compliance |
| Zdroj: | Journal of Endovascular Therapy. 13:406-414 |
| ISSN: | 1545-1550 1526-6028 |
| DOI: | 10.1583/06-1848.1 |
| Popis: | To utilize dynamic magnetic resonance angiography (MRA) to characterize aortic stiffness (beta) and elastic modulus (Ep) as indexes of wall compliance during the cardiac cycle and determine any influence of different endograft designs or the presence of endoleaks on these indexes.Eleven consecutive patients (11 men; median age 74 years, range 63-78) with abdominal aortic aneurysm (AAA) selected for endovascular repair were scanned pre- and postoperatively. Aortic area and diameter changes during the cardiac cycle were determined using dynamic MRA at 4 levels: 3 cm above the renal arteries, between the renal arteries, 1 cm below the renal arteries, and at the level of maximum aneurysm sac diameter. Ep and beta were calculated. Data are presented as median (range); p0.05 was considered significant.Preoperatively, Ep and beta were significantly higher at the level of the aneurysm sac compared to all other levels (p0.05). Following EVAR, stiffness increased at this level (p0.05). After implantation, patients with an Excluder endograft demonstrated Ep and beta measurements at the aneurysm neck that were 94% and 60% higher, respectively, compared to those with a Talent (p0.05) endograft. The presence of an endoleak had no effect on Ep or beta.This study introduces the feasibility of dynamic MRA imaging-based calculations of aortic elastic modulus and stiffness. AAA patients demonstrate increased Ep and beta at the level of the aneurysm sac. EVAR results in increased aneurysm sac Ep and beta. Stent-graft design seems to alter Ep and beta within the aneurysm neck, which may have consequences for endograft durability. The presence of an endoleak does not seem to have an effect on Ep or beta. |
| Databáze: | OpenAIRE |
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