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Geometrical Factors Influencing the Hemodynamic Behavior of the AAA Stent Grafts: Essentials for the Clinician

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Abstract

Endovascular aneurysm repair (EVAR) is considered to be the treatment of choice for abdominal aortic aneurysms (AAA). Despite the initial technical success, EVAR is amenable to early and late complications, among which the migration of the endograft (EG) with subsequent proximal endoleak (Type Ia) leads to repressurization of the AAA sac, exposure to excessive wall stress, and, hence, to potential rupture. This article discusses the influence that certain geometrical factors, such as neck angulation, iliac bifurcation, EG curvature, neck-to-iliac diameter, and length ratios, as well as iliac limbs configuration can exert on the hemodynamic behavior of the EGs. The information provided could help both clinicians and EG manufacturers towards further development and improvement of EG designs and better operational planning.

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Acknowledgments

The authors thank Prof. S. Tsangaris, MEng, PhD and Antonios Xenakis, MEng (Fluids Section, School of Mechanical Engineering, National Technical University of Athens, Athens, Greece) for their technical support.

Conflict of interest

Efstratios Georgakarakos, Christos Argyriou, Nikolaos Schoretsanitis, Chris V. Ioannou, Nikolaos Kontopodis, Robert Morgan declare that they have no conflict of interest. Dimitrios Tsetis; Dr. Tsetis gives lectures for Trivascular outside the scope of this article.

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Authors and Affiliations

  1. Department of Vascular Surgery, University Hospital of Alexandroupolis, “Democritus” University of Thrace, Alexandroupolis, Greece

    Efstratios Georgakarakos, Christos Argyriou & Nikolaos Schoretsanitis

  2. Vascular Surgery Department, University of Crete Medical School, Heraklion, Crete, Greece

    Chris V. Ioannou & Nikolaos Kontopodis

  3. Department of Radiology, St. George’s Hospital, London, UK

    Robert Morgan

  4. Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, 71110, Heraklion, Crete, Greece

    Dimitrios Tsetis

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  1. Efstratios Georgakarakos
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  2. Christos Argyriou
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Correspondence to Dimitrios Tsetis.

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Georgakarakos, E., Argyriou, C., Schoretsanitis, N. et al. Geometrical Factors Influencing the Hemodynamic Behavior of the AAA Stent Grafts: Essentials for the Clinician. Cardiovasc Intervent Radiol 37, 1420–1429 (2014). https://doi.org/10.1007/s00270-014-0927-9

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