Aortic Curvature Remodeling after Thoracic Endovascular Aortic Repair: Assessing Device Conformability, Using Image Vector Analysis

被引:1
|
作者
Mestres, Gaspar [1 ]
Blanco, Carla [1 ]
Martinez, Isaac [2 ]
Fernandez Noya, Jorge [3 ]
Inaraja-Perez, Gabriel C. [4 ]
Antonio del Castro, Jose [5 ]
Miguel Salmeron, Luis [6 ]
Malo, Nahieli [1 ]
Riambau, Vincent [1 ]
机构
[1] Hosp Clin Barcelona, C Villarroel 170, Barcelona 08036, Spain
[2] Hosp Clin San Carlos, Madrid, Spain
[3] Complejo Hosp Univ Santiago, Santiago De Compostela, Spain
[4] Hosp Miguel Servet, Zaragoza, Spain
[5] Hosp Univ Cent Asturias, Oviedo, Spain
[6] Hosp Univ San Cecilio, Granada, Spain
关键词
IMPACT; ANGULATION; ARCH;
D O I
10.1016/j.avsg.2018.09.019
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Aortic arch curvature can be straightened by endograft placement. However, different measurement methods with dissimilar follow-up and endografts have been published. The aim of this study was to corroborate, for the first time, the pliability of the Conformable Gore TAG Thoracic Endoprosthesis (W.L. Gore and Associates, Flagstaff, AZ, USA) into the aortic arch, using different image vector analysis. Material and Methods: We, retrospectively, analyzed patients primarily treated for thoracic aortic aneurysms and blunt traumatic aortic injuries by means of a Conformable Gore TAG Thoracic Endoprosthesis endograft proximally sealed into the aortic arch (zones Z1-Z3) in five different Spanish centers, between 2010 and 2017. The preoperative, one-month and sixmonth postoperative, computed tomography angiographies (CTAs) were obtained, creating accurate 3D center lumen line and external lumen line from the aortic valve to the renal arteries. Three different image analysis methods were used to compare modifications of the aortic curvature: first, segment analysis (angulations of the center lumen line when divided into seven precise segments, examining anterior-posterior, right-left, and cranial-caudal displacement), second, center lumen line analysis (bending of the center lumen line itself in seven definite points), and third, expected behavior (length of the endograft in the external lumen line). Two independent observers performed a blind analysis of all CTAs. Changes between preoperative and postoperative CTAs at one and six months are compared, and differences are viewed between cases sealed proximally (Z1-Z2) and distally (Z3) into the aortic arch. Results: We analyzed 37 cases. At 1- and 6-month follow-ups, minimal changes occurred first in segment analysis (only a slight decrease of -2.0 degrees in the XY plane at 10 cm from the brachiocephalic trunk at six-month follow-up was seen, P = 0.027). Second, center lumen line analysis again only showed negligible aortic curvature straightening (+3.5 degrees at 10 cm from the brachiocephalic trunk at one month, P= 0.006, disappearing at six-month follow-up). Finally, good device length predictability was shown (interclass correlation coefficients: 0.995 and 0.994 at one and six months, P> 0.001). No differences were seen between cases proximally sealed into the proximal and distal aortic arch. Conclusions: Conformable Gore TAG Thoracic Endoprosthesis thoracic endograft showed a good pliability into the aortic arch and proximal thoracic aorta, with minimal changes in the aortic curvature after endograft placement in the short-term follow-up (up to six months). In addition, final endograft length into outer aortic curvature is highly predictable.
引用
收藏
页码:216 / 223
页数:8
相关论文
共 50 条
  • [1] Aortic Arch and Thoracic Aorta Curvature Remodeling after Thoracic Endovascular Aortic Repair
    Mestres, Gaspar
    Garcia, Marvin E.
    Yugueros, Xavier
    Urrea, Rodrigo
    Tripodi, Paolo
    Gomez, Fernando
    Maeso, Jordi
    Riambau, Vincent
    ANNALS OF VASCULAR SURGERY, 2017, 38 : 233 - 241
  • [2] Aortic remodeling after thoracic endovascular aortic repair for intramural hematoma
    Lavingia, Kedar S.
    Ahanchi, Sadaf S.
    Redlinger, Richard E.
    Udgiri, Navalkishor R.
    Panneton, Jean M.
    JOURNAL OF VASCULAR SURGERY, 2014, 60 (04) : 929 - 935
  • [3] Thoracic aortic remodeling with endografting after a decade of thoracic endovascular aortic repair experience
    Tanious, Adam
    Boitano, Laura
    Canha, Lauren
    Chou, Elizabeth L.
    Wang, Linda J.
    Latz, Christopher
    Eagleton, Matthew J.
    Conrad, Mark F.
    JOURNAL OF VASCULAR SURGERY, 2021, 73 (03) : 844 - 849
  • [4] Assessing Aortic Remodeling after Thoracic Endovascular Aortic Repair (TEVAR) in DeBakey IIIb Aortic Dissection: A Retrospective Study
    Zhou, Wei
    Yu, Wanjiang
    Wang, Yunying
    Li, Ying
    Sheng, Wei
    Wang, Qingjiang
    Xu, Wenjian
    ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY, 2019, 25 (01) : 46 - 55
  • [5] Aortic remodeling after thoracic endovascular aortic repair for intramural hematoma DISCUSSION
    Dattilo, Jeffery B.
    Lavingia, Kedar S.
    JOURNAL OF VASCULAR SURGERY, 2014, 60 (04) : 935 - 936
  • [6] More Than a Decade With Thoracic Endovascular Aortic Repair: Thoracic Aortic Remodeling After Endografting
    Tanious, Adam
    Canha, Lauren
    Boitano, Laura T.
    Chou, Elizabeth
    Wang, Linda J.
    Latz, Christopher A.
    Eagleton, Matthew J.
    Clouse, W. Darrin
    Conrad, Mark F.
    JOURNAL OF VASCULAR SURGERY, 2019, 70 (03) : E52 - E53
  • [7] Remodeling of abdominal aortic branch perfusion after thoracic endovascular aortic repair for aortic dissections
    Farber, Mark
    Han, Sukgu M.
    JOURNAL OF VASCULAR SURGERY, 2016, 64 (04) : 910 - 911
  • [8] Thoracic Aortic Aneurysm Sac Remodeling After Thoracic Endovascular Aortic Repair Affects Late Outcomes After Repair
    Patel, Priya
    Marcaccio, Christina
    O'Donnell, Thomas
    Elmously, Adham
    Garg, Karan
    Schermerhorn, Marc
    Takayama, Hiroo
    Patel, Virendra
    JOURNAL OF VASCULAR SURGERY, 2022, 76 (03) : E22 - E22
  • [9] Thoracic Aortic Aneurysm Sac Remodeling After Thoracic Endovascular Aortic Repair Affects Late Outcomes After Repair
    Patel, Priya B.
    Marcaccio, Christina L.
    O'Donnell, Thomas F.
    Rao, Abhishek
    Iannuzzi, James C.
    Siracuse, Jeffrey J.
    Garg, Karan
    Schermerhorn, Marc L.
    Takayama, Hiroo
    Patel, Virendra
    JOURNAL OF VASCULAR SURGERY, 2022, 75 (06) : E261 - E262
  • [10] Discriminant Analysis of Native Thoracic Aortic Curvature: Risk Prediction for Endoleak Formation After Thoracic Endovascular Aortic Repair
    Nakatamari, Hazuki
    Ueda, Takuya
    Ishioka, Fumio
    Raman, Bhargav
    Kurihara, Koji
    Rubin, Geoffrey D.
    Ito, Hisao
    Sze, Daniel Y.
    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2011, 22 (07) : 974 - 979