Document Detail


The influence of different types of stent grafts on aneurysm neck dynamics after endovascular aneurysm repair.
MedLine Citation:
PMID:  19879781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Dynamic imaging provides insight into aortic shape changes throughout the cardiac cycle. These changes may be important for proximal aortic stent graft fixation, sealing and durability. The objective of this study is to analyse the influence of different types of stent grafts on dynamic changes of the aneurysm neck. METHODS: Pre- and postoperative electrocardiography (ECG)-gated computed tomographic angiography (CTA) scans were obtained in 30 abdominal aortic aneurysm (AAA) patients, 10 each from three different types of stent grafts (10 Talent, Endurant, and Excluder). Each dynamic CTA dataset consisted of eight reconstructed images over the cardiac cycle. Aortic area and radius changes during the cardiac cycle were determined at two levels: (A) 3 cm above and (B) 1 cm below the lowermost renal artery. Radius changes were measured over 360 axes, and plotted in a polar plot. An ellipse was fitted over the plots to determine radius changes over the major and minor axis for assessment of the asymmetric aspect and most prominent direction of distension. RESULTS: Baseline characteristics did not differ significantly between the three groups. Preoperatively, the aortic area increased significantly (p < 0.001) over the cardiac cycle in all patients at both levels: (A) mean increase 8.3 +/- 4.1% (2.0-17.3%); (B) mean increase 5.9 +/- 4.2% (1.9-12.4%). The postoperative aortic area increase over the cardiac cycle did not differ significantly from preoperative increases: (A) mean increase 9.9 +/- 2.2% (4.4-20.0%); (B) mean increase 7.7 +/- 2.4% (3.8-12.4%). The difference between radius change over the major and minor axis was significant both pre- and postoperatively for all three stent grafts, indicating asymmetric distension. Suprarenal, the distension showed a tendency to right-anterior and infrarenal to left-anterior. The distension and direction of the aortic expansion was preserved after stent grafting. There were no differences between the three types of stent grafts regarding their impact on the aortic distension or direction of this distension. CONCLUSION: The aorta expands significantly and asymmetrically throughout the cardiac cycle. After implantation of abdominal aortic stent grafts, the aortic distension and direction of distension remain equally preserved in all three groups. The three stent graft types studied seem to be able to adapt to the asymmetric dynamic aortic shape changes.
Authors:
J W van Keulen; K L Vincken; J van Prehn; J L Tolenaar; L W Bartels; M A Viergever; F L Moll; J A van Herwaarden
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-10-30
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  39     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2010-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  193-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Algorithms
Aortic Aneurysm, Abdominal / pathology,  radiography*,  surgery*
Blood Vessel Prosthesis*
Electrocardiography
Female
Humans
Male
Middle Aged
Pulsatile Flow
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Stents*
Tomography, Spiral Computed / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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