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Geometric Deformations of the Thoracic Aorta and Supra-Aortic Arch Branch Vessels Following Thoracic Endovascular Aortic Repair.
Vascular and endovascular surgery
  • Brant W Ullery, Providence Heart and Vascular Institute, Portland, OR, USA.
  • Ga-Young Suh
  • Kelsey Hirotsu
  • David Zhu
  • Jason T Lee
  • Michael D Dake
  • Dominik Fleischmann
  • Christopher P Cheng
Document Type
Article
Publication Date
4-1-2018
Keywords
  • aortic aneurysm,
  • aortic arch,
  • aortic dissection,
  • geometric deformation,
  • supra-aortic arch,
  • thoracic endovascular aortic repair,
  • vessel geometry,
  • cards
Disciplines
Abstract

OBJECTIVE: To utilize 3-D modeling techniques to better characterize geometric deformations of the supra-aortic arch branch vessels and descending thoracic aorta after thoracic endovascular aortic repair.

METHODS: Eighteen patients underwent endovascular repair of either type B aortic dissection (n = 10) or thoracic aortic aneurysm (n = 8). Computed tomography angiography was obtained pre- and postprocedure, and 3-D geometric models of the aorta and supra-aortic branch vessels were constructed. Branch angle of the supra-aortic branch vessels and curvature metrics of the ascending aorta, aortic arch, and stented thoracic aortic lumen were calculated both at pre- and postintervention.

RESULTS: The left common carotid artery branch angle was lower than the left subclavian artery angles preintervention ( P < .005) and lower than both the left subclavian and brachiocephalic branch angles postintervention ( P < .05). From pre- to postoperative, no significant change in branch angle was found in any of the great vessels. Maximum curvature change of the stented lumen from pre- to postprocedure was greater than those of the ascending aorta and aortic arch ( P < .05).

CONCLUSION: Thoracic endovascular aortic repair results in relative straightening of the stented aortic region and also accentuates the native curvature of the ascending aorta when the endograft has a more proximal landing zone. Supra-aortic branch vessel angulation remains relatively static when proximal landing zones are distal to the left common carotid artery.

Area of Special Interest
Cardiovascular (Heart)
Specialty/Research Institute
Cardiology
Specialty/Research Institute
Surgery
Citation Information
Brant W Ullery, Ga-Young Suh, Kelsey Hirotsu, David Zhu, et al.. "Geometric Deformations of the Thoracic Aorta and Supra-Aortic Arch Branch Vessels Following Thoracic Endovascular Aortic Repair." Vascular and endovascular surgery (2018)
Available at: http://works.bepress.com/brantw-ullery/11/