Thoracic aortic geometry correlates with endograft bird-beaking severity

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Frohlich, Maxfield M.San Jose State University (author)

Thoracic aortic geometry correlates with endograft bird-beaking severity

Article/chapterEnglish2020

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Elsevier BV,2020
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LIBRIS-ID:oai:research.chalmers.se:dc962672-f409-4b7c-809a-e4748f242b0c
https://research.chalmers.se/publication/515552URI
https://research.chalmers.se/publication/515428URI
https://doi.org/10.1016/j.jvs.2019.11.045DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype

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Objective: Aortic geometry has been shown to influence the development of endograft malapposition (bird-beaking) in thoracic endovascular aortic repair (TEVAR), but the extent of this relationship lacks clarity. The aim of this study was to develop a reproducible method of measuring bird-beak severity and to investigate preoperative geometry associated with bird-beaking. Methods: The study retrospectively analyzed 20 patients with thoracic aortic aneurysms or type B dissections treated with TEVAR. Computed tomography scans were used to construct three-dimensional geometric models of the preoperative and postoperative aorta and endograft. Postoperative bird-beaking was quantified with length, height, and angle; categorized into a bird-beak group (BBG; n = 10) and no bird-beak group (NBBG; n = 10) using bird-beak height ≥5 mm as a threshold; and correlated to preoperative metrics including aortic cross-sectional area, inner curvature, diameter, and inner curvature × diameter as well as graft diameter and oversizing at the proximal landing zone. Results: Aortic area (1002 ± 118 mm2 vs 834 ± 248 mm2), inner curvature (0.040 ± 0.014 mm−1 vs 0.031 ± 0.012 mm−1), and diameter (35.7 ± 2.1 mm vs 32.2 ± 4.9 mm) were not significantly different between BBG and NBBG; however, inner curvature × diameter was significantly higher in BBG (1.4 ± 0.5 vs 1.0 ± 0.3; P =.030). Inner curvature and curvature × diameter were significantly correlated with bird-beak height (R = 0.462, P =.041; R = 0.592, P =.006) and bird-beak angle (R = 0.680, P <.001; R = 0.712, P <.001). Conclusions: TEVAR bird-beak severity can be quantified and predicted with geometric modeling techniques, and the combination of high preoperative aortic inner curvature and diameter increases the risk for development of TEVAR bird-beaking.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Oto-rhino-laryngologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Otorhinolaryngology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Endograft
Bird beak configuration
Thoracic endovascular aortic repair
Aortic arch
Endoleak

Added entries (persons, corporate bodies, meetings, titles ...)

Suh, Ga YoungThe California State University, United States (author)
Bondesson, Johan,1991Chalmers tekniska högskola,Chalmers University of Technology(Swepub:cth)johbond (author)
Leineweber, MatthewSan Jose State University (author)
Lee, Jason T.Stanford University (author)
Dake, Michael D.Stanford University (author)
Cheng, ChristopherStanford University (author)
The California State University, United StatesSan Jose State University (creator_code:org_t)

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In:Journal of Vascular Surgery: Elsevier BV72:4, s. 1196-12050741-52141097-6809

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