In Vitro Quantification of Gutter Formation and Chimney Graft Compression in Chimney EVAR Stent-Graft Configurations Using Electrocardiography-Gated Computed Tomography
| Autor: | Jorrit T. Boersen, Erik Groot Jebbink, Simon P. Overeem, Michel M.P.J. Reijnen, Jean-Paul P.M. de Vries, Cornelis H. Slump, Esmé J. Donselaar |
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| Přispěvatelé: | Physics of Fluids |
| Rok vydání: | 2018 |
| Předmět: |
Models
Anatomic medicine.medical_treatment UT-Hybrid-D 030204 cardiovascular system & hematology Endovascular aneurysm repair 030218 nuclear medicine & medical imaging endovascular aneurysm repair Electrocardiography 0302 clinical medicine Materials Testing Chimney dynamic computed tomography Cardiac cycle gutter stent compression aneurysm diameter self-expanding stent-graft Endovascular Procedures Models Cardiovascular endograft ECG-gated computed tomography Abdominal aortic aneurysm Pulsatile Flow Stents Cardiology and Cardiovascular Medicine in vitro study Cardiac-Gated Imaging Techniques Diastole endoleak Lumen (anatomy) Prosthesis Design Blood Vessel Prosthesis Implantation 03 medical and health sciences abdominal aortic aneurysm Aneurysm flow model Multidetector Computed Tomography medicine Arterial Pressure Radiology Nuclear Medicine and imaging aneurysm model stent-graft volume business.industry chimney graft Stent cardiac cycle medicine.disease 22/4 OA procedure Blood Vessel Prosthesis Surgery business Nuclear medicine Aortic Aneurysm Abdominal |
| Zdroj: | Journal of Endovascular Therapy, 25(3), 387-394. Sage |
| ISSN: | 1545-1550 1526-6028 |
| DOI: | 10.1177/1526602818762399 |
| Popis: | Purpose: To assess the dynamic behavior of chimney grafts during the cardiac cycle. Methods: Three chimney endovascular aneurysm repair (EVAR) stent-graft configurations (Endurant and Advanta V12, Endurant and Viabahn, and Endurant and BeGraft) were placed in silicone aneurysm models and subjected to physiologic flow. Electrocardiography (ECG)-gated contrast-enhanced computed tomography was used to visualize geometric changes during the cardiac cycle. Endograft and chimney graft surface, gutter volume, chimney graft angulation over the center lumen line, and the D-ratio (the ratio between the lengths of the major and minor axes) were independently assessed by 2 observers at 10 time points in the cardiac cycle. Results: Both gutter volumes and chimney graft geometry changed significantly during the cardiac cycle in all 3 configurations (p3) and change in volume (20.7 mm3) between systole and diastole were observed in the Endurant-Advanta configuration. These values were 2.7- and 3.0-fold higher, respectively, compared to the Endurant-Viabahn configuration and 1.7- and 1.6-fold higher as observed in the Endurant-BeGraft configuration. The Endurant-Viabahn configuration had the highest D-ratio (right, 1.26–1.35; left, 1.33–1.48), while the Endurant-BeGraft configuration had the lowest (right, 1.11–1.17; left, 1.08–1.15). Assessment of the interobserver variability showed a high correlation (intraclass correlation >0.935) between measurements. Conclusion: Gutter volumes and stent compression are dynamic phenomena that reshape during the cardiac cycle. Compelling differences were observed during the cardiac cycle in all configurations, with the self-expanding (Endurant–Viabahn) chimney EVAR configurations having smaller gutters and less variation in gutter volume during the cardiac cycle yet more stent compression without affecting the chimney graft surface. |
| Databáze: | OpenAIRE |
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