Abstract
Aortic morphology is associated with age, with the diameter being larger in older people. Thoracic endovascular aortic repair (TEVAR) is a treatment for aortic diseases, such as aortic dissection. When evaluating patients, aortic elongation could interfere with the classification of TEVAR complications. The longitudinal change in aortic length has not been studied in detail. In patients receiving thoracic endovascular aortic repair between 2007 and 2013, we determined the aortic length between the sinotubular junction, left common carotid artery, subclavian artery, and celiac artery on their first five annual follow-up computed tomography (CT) exams. Using the immediate post-TEVAR follow-up CT as the comparison reference and a lengthening of the aortic segment by 10 mm or more as the definition of elongation, 16 of 41 (39%) showed elongation between the innominate artery and celiac artery. When compared with the immediate follow-up CT, a higher proportion of patients showed elongation at the fifth year’s follow-up CT than the first year’s follow-up CT (p < 0.01), and the average lengthening per year was 1.7 mm. There was progressive lengthening of the aorta after TEVAR.
Highlights
Aortic morphology has been reported to be associated with age
The current study showed that, at the follow-up computed tomography (CT), there was lengthening of the thoracic aorta, including the sinotubular junction to innominate artery and innominate artery to celiac artery, in patients receiving Thoracic endovascular aortic repair (TEVAR)
Mean differences in aortic length were noted at multiple aortoiliac segments, while there was no significant change in iliofemoral segments
Summary
A study of 123 subjects without thoracic aorta pathology or surgery found that the aortic diameter enlarges, the posterior arch elongates, the tortuosity index decreases, and the attachment zone angle is larger in older people [1]. Age had a correlation coefficient of 0.61 with arch length (p < 0.01) in the study. Another study consisted of consecutive patients who received a computed tomography (CT) scan and found that the thoracic aorta was significantly related to age, with a correlation coefficient of 0.54 [2]. Ascending aortic length per centimeter was reported to have an odds ratio of 5.3 for ascending aortic dissection [4]. These studies were cross-sectional studies, and the exact longitudinal change of aortic length was not clear
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