Geometric Analysis to Determine Kinking and Shortening of Bridging Stents After Branched Endovascular Aortic Repair

Purpose To evaluate bridging stent geometry in patients who underwent branched endovascular aortic repair (B-EVAR) and to correlate the outcomes with intrinsic bridging stent characteristics aiming to identify the stent(s) that guarantees the best performance. Methods Pre-operative and post-operativ...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2021-05, Vol.44 (5), p.711-719
Main Authors: Finotello, Alice, Spinella, Giovanni, Notini, Giulia, Palombo, Domenico, Pratesi, Giovanni, Mambrini, Simone, Auricchio, Ferdinando, Conti, Michele, Pane, Bianca
Format: Article
Language:English
Subjects:
Aorta
Aortic aneurysms
Arterial Interventions
Arteries
Cardiology
Cardiovascular system
Clinical Investigation
Computed tomography
Diameters
Early experience
Imaging
Implants
Kinking
Medicine
Medicine & Public Health
Nuclear Medicine
Radiology
Renal artery
Stents
Surgical implants
Ultrasound
Vascular surgery
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Summary:Purpose To evaluate bridging stent geometry in patients who underwent branched endovascular aortic repair (B-EVAR) and to correlate the outcomes with intrinsic bridging stent characteristics aiming to identify the stent(s) that guarantees the best performance. Methods Pre-operative and post-operative computed tomography images of all patients undergoing B-EVAR between September 2016 and April 2019 were retrospectively analyzed. Following geometrical features were measured: target vessel take-off angle (TOA); longitudinal stent shortening; shape index (SI), intended as ratio between minimum and maximum diameter of the lumen cross sections, averaged on three segments: zone 1 (proximal stented zone), zone 2 (intermediate), and zone 3 (distal). Results Thirty-eight branches (8 right (RRA) and 8 left renal arteries (LRA), 11 superior mesenteric arteries (SMA), 11 celiac trunks (CTR)) were treated. Fluency (Bard Peripheral Vascular), COVERA (Bard Peripheral Vascular), and VBX (WLGore&Assoc) stent-grafts were implanted in 10, 12, and 16 branches, respectively. Pre-operative TOA was more acute in RRA and LRA when compared to CTR and SMA, and straightened in post-operative configuration (109.86 ± 28.65° to 150.27 ± 21.0°; P  
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-021-02773-w