Abstract
Purpose
Although the widespread acceptance of thoracic endovascular aortic repair (TEVAR) as a first-line treatment option for a multitude of thoracic aortic diseases, little is known about the consequences of the device implantation on the native aortic anatomy. We propose a comparative analysis of the pre- and postoperative geometry on a clinical series of patients and discuss the potential clinical implications
Methods
CT pre- and postoperative acquisitions of 30 consecutive patients treated by TEVAR for different pathologies (20 thoracic aortic aneurysms, 6 false aneurysms, 3 penetrating ulcers, 1 traumatic rupture) were used to model the vascular geometry. Pre- and postoperative geometries were compared for each patient by pairing and matching the 3D models. An implantation site was identified, and focal differences were detected and described.
Results
Segmentation of the data sets was successfully performed for all 30 subjects. Geometry differences between the pre- and postoperative meshes were depicted in 23 patients (76 %). Modifications at the upper implantation site were detected in 14 patients (47 %), and among them, the implantation site involved the arch (Z0–3) in 11 (78 %).
Conclusion
Modeling the vascular geometry on the basis of imaging data offers an effective tool to perform patient-specific analysis of the vascular geometry before and after the treatment. Future studies will evaluate the consequences of these changes on the aortic function.
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Acknowledgments
Marco Midulla was supported during the development of his PhD project, of which this article is a part, by a grant from the French Society of Radiology (SFR). The entire project OCFIA is supported by the French National Agency for Research (ANR 07-CIS7-006-01).
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The authors declare that they have no conflict of interest.
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Midulla, M., Moreno, R., Negre-Salvayre, A. et al. Impact of Endografting on the Thoracic Aortic Anatomy: Comparative Analysis of the Aortic Geometry before and after the Endograft Implantation. Cardiovasc Intervent Radiol 37, 69–76 (2014). https://doi.org/10.1007/s00270-013-0601-7
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DOI: https://doi.org/10.1007/s00270-013-0601-7