Thoracic aortic geometry correlates with endograft bird-beaking severity
| Autor: | Matthew J. Leineweber, Christopher P. Cheng, Ga-Young Suh, Johan Bondesson, Maxfield M. Frohlich, Michael D. Dake, Jason T. Lee |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Models Anatomic Aortic arch animal structures Endoleak Aorta Thoracic Aortic area Geometry Computed tomography 030204 cardiovascular system & hematology Aortic repair Aortography Risk Assessment Severity of Illness Index 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine medicine.artery medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Aorta Aortic Aneurysm Thoracic medicine.diagnostic_test business.industry Endovascular Procedures Middle Aged body regions Landing zone Preoperative Period Feasibility Studies Equipment Failure Female Stents Surgery Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular Surgery. 72:1196-1205 |
| ISSN: | 0741-5214 |
| Popis: | Objective Aortic geometry has been shown to influence the development of endograft malapposition (bird-beaking) in thoracic endovascular aortic repair (TEVAR), but the extent of this relationship lacks clarity. The aim of this study was to develop a reproducible method of measuring bird-beak severity and to investigate preoperative geometry associated with bird-beaking. Methods The study retrospectively analyzed 20 patients with thoracic aortic aneurysms or type B dissections treated with TEVAR. Computed tomography scans were used to construct three-dimensional geometric models of the preoperative and postoperative aorta and endograft. Postoperative bird-beaking was quantified with length, height, and angle; categorized into a bird-beak group (BBG; n = 10) and no bird-beak group (NBBG; n = 10) using bird-beak height ≥5 mm as a threshold; and correlated to preoperative metrics including aortic cross-sectional area, inner curvature, diameter, and inner curvature × diameter as well as graft diameter and oversizing at the proximal landing zone. Results Aortic area (1002 ± 118 mm2 vs 834 ± 248 mm2), inner curvature (0.040 ± 0.014 mm−1 vs 0.031 ± 0.012 mm−1), and diameter (35.7 ± 2.1 mm vs 32.2 ± 4.9 mm) were not significantly different between BBG and NBBG; however, inner curvature × diameter was significantly higher in BBG (1.4 ± 0.5 vs 1.0 ± 0.3; P = .030). Inner curvature and curvature × diameter were significantly correlated with bird-beak height (R = 0.462, P = .041; R = 0.592, P = .006) and bird-beak angle (R = 0.680, P Conclusions TEVAR bird-beak severity can be quantified and predicted with geometric modeling techniques, and the combination of high preoperative aortic inner curvature and diameter increases the risk for development of TEVAR bird-beaking. |
| Databáze: | OpenAIRE |
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