Spatial Configuration of Abdominal Aortic Aneurysm Analysis as a Useful Tool for the Estimation of Stent-Graft Migration.

Andrzej Polanczyk,Michał Strzelecki,Ludomir Stefańczyk,Aleksandra Piechota-Polanczyk

doi:10.3390/diagnostics10100737

Andrzej Polanczyk, Michał Strzelecki + Show 2 more

Open Access

https://doi.org/10.3390/diagnostics10100737

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Abstract

The aim of this study was to prepare a self-made mathematical algorithm for the estimation of risk of stent-graft migration with the use of data on abdominal aortic aneurysm (AAA) size and geometry of blood flow through aneurysm sac before or after stent-graft implantation. AngioCT data from 20 patients aged 50–60 years, before and after stent-graft placement in the AAA was analyzed. In order to estimate the risk of stent-graft migration for each patient we prepared an opposite spatial configuration of virtually reconstructed stent-graft with long body or short body. Thus, three groups of 3D geometries were analyzed: 20 geometries representing 3D models of aneurysm, 20 geometries representing 3D models of long body stent-grafts, and 20 geometries representing 3D models of short body stent-graft. The proposed self-made algorithm demonstrated its efficiency and usefulness in estimating wall shear stress (WSS) values. Comparison of the long or short type of stent-graft with AAA geometries allowed to analyze the implants’ spatial configuration. Our study indicated that short stent-graft, after placement in the AAA sac, generated lower drug forces compare to the long stent-graft. Each time shape factor was higher for short stent-graft compare to long stent-graft.

Highlights

The XX and XXI centuries are characterized by prolongation of life span and increasing number of people diagnosed with an abdominal aortic aneurysm (AAA), that occurs in 5% of the society elder that 65 years of age [1]
It was observed that short stent‐graft, after placement in the AAA, generated higher was characterized by higher value for short stent-grafts compare to long stent-grafts
It was observed that lower value of shape factor was presented for lower wall shear stress (WSS) values

Summary

Introduction

The XX and XXI centuries are characterized by prolongation of life span and increasing number of people diagnosed with an abdominal aortic aneurysm (AAA), that occurs in 5% of the society elder that 65 years of age [1]. When the diameter is lower than 40 mm pharmacological treatment is applied [2,3], while AAA with diameter equal or above 55 mm and growth rate over 5 mm every 6 months require surgical repair either open or endovascular [4]. Endovascular aortic aneurysm repair (EVAR) is “less” invasive and characterized by lower postoperative complications and mortality rate [5]. Potential complications of EVAR, such as endoleaks, migration or appearance of angular bands in the stent-graft (SG) body or legs, have raised concerns about its durability. Computational tomography (CT) and magnetic resonance angiography (MRA) are useful tools for diagnostic purposes because they can detect thrombus both inside the endograft and native

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