University of Colorado Hospital, Aurora, Colorado 80045, USA.
Catheter Cardiovasc Interv. 2009 Nov 1;74(5):787-98. doi: 10.1002/ccd.22124.
The unique physical forces exerted on the femoropopliteal (FP) artery during movement have been implicated in the high rates of restenosis and stent fracture in this artery. Conformational changes in the FP artery during movement are important surrogates of these forces. This study sought to quantify the conformational change in the FP artery between the straight-leg (SL) and crossed-leg (CL) positions.
Using paired angiographic images of overlapping segments of the FP artery in SL and CL positions from patients with peripheral arterial disease, 3-D models of individual segments were generated and subsequently fused to create a 3-D model of the entire FP artery in both leg positions. Based on these 3-D models, the following parameters in the SL and CL positions were quantitatively assessed for the superficial femoral artery (SFA), popliteal artery (PA), and FP artery (i.e., SFA and PA): length, curvature, torsion, twist angle, and development of new flexion angles = 15 degrees.
In nine male patients with a mean age of 57 +/- 10.2 years, angiography was performed in 10 FP arteries, with successful generation of 3-D models for all vessels. Movement from the SL to the CL position for the SFA, PA, and FP artery was associated with (a) a mean shortening of 18.2 mm (P = 0.002), 32.2 mm (P < 0.001), and 50.3 mm (P < 0.001), respectively; (b) a mean increase in curvature of 0.04 cm(-1) (P = 0.012), 0.2 cm(-1) (P < 0.001), and 0.11 cm(-1) (P < 0.001), respectively; (c) and small absolute changes in mean torsion of 0.034 cm(-1) (P = 0.48), 0.006 cm(-1) (P < 0.001), and 0.057 cm(-1) (P < 0.001), respectively. The same leg movement was associated with a mean twist angle of 45.6 degrees +/- 27.9 degrees (range of 17.4 degrees-103.4 degrees ) and 61.1 degrees +/- 31.9 degrees (range of 20.5 degrees-101.1 degrees ) for the SFA and PA, respectively. Compared to the SL position, the CL position induced a single flexion point (FxP) =15 degrees in the SFA in two patients, and a mean of 2.4 FxPs =15 degrees (range 1-5) in the PA.
Significant changes in length, curvature, and twist occur in the PA and significant but more modest changes in length and twist occur in the SFA during movement from the SL to the CL position. This data has important implications for endovascular therapies that are used to treat disease in the FP artery.
在运动过程中，股浅动脉（FP）所承受的独特物理力与该动脉中再狭窄和支架断裂的高发生率有关。FP 动脉在运动过程中的构象变化是这些力的重要替代指标。本研究旨在定量测量 FP 动脉在直腿（SL）和交叉腿（CL）位置之间的构象变化。
使用来自外周动脉疾病患者的 FP 动脉 SL 和 CL 位置重叠段的配对血管造影图像，生成各个段的 3D 模型，然后融合以创建 SL 和 CL 位置中整个 FP 动脉的 3D 模型。基于这些 3D 模型，定量评估 SL 和 CL 位置中的以下参数：股浅动脉（SFA）、腘动脉（PA）和 FP 动脉（即 SFA 和 PA）的长度、曲率、扭转、扭转角度和新弯曲角度的发展 = 15 度。
在 9 名平均年龄为 57 +/- 10.2 岁的男性患者中，对 10 个 FP 动脉进行了血管造影检查，所有血管均成功生成了 3D 模型。从 SL 到 CL 位置的运动与（a）SFA、PA 和 FP 动脉的平均缩短 18.2 毫米（P = 0.002）、32.2 毫米（P < 0.001）和 50.3 毫米（P < 0.001）有关；（b）曲率的平均增加分别为 0.04 cm（-1）（P = 0.012）、0.2 cm（-1）（P < 0.001）和 0.11 cm（-1）（P < 0.001）；（c）扭转的平均绝对值变化分别为 0.034 cm（-1）（P = 0.48）、0.006 cm（-1）（P < 0.001）和 0.057 cm（-1）（P < 0.001）。相同的腿部运动与 SFA 和 PA 的平均扭转角度分别为 45.6 度 +/- 27.9 度（范围 17.4 度-103.4 度）和 61.1 度 +/- 31.9 度（范围 20.5 度-101.1 度）有关。与 SL 位置相比，CL 位置在 2 名患者的 SFA 中引起单个弯曲点（FxP）=15 度，在 PA 中引起平均 2.4 个 FxP =15 度（范围 1-5）。
在从 SL 到 CL 位置的运动过程中，PA 的长度、曲率和扭转发生明显变化，而 SFA 的长度和扭转发生明显但更适度的变化。这些数据对外周血管内治疗具有重要意义，这些治疗用于治疗 FP 动脉中的疾病。
