Suh Ga-Young, Bondesson Johan, Zhu Yufei D, Lee Jason T, Dake Michael D, Cheng Christopher P
Department of Biomedical Engineering, California State University, Long Beach: 1250 Bellflower Blvd, Long Beach, CA, 90840, USA.
Department of Vascular Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
Eur J Radiol Open. 2021 Mar 11;8:100333. doi: 10.1016/j.ejro.2021.100333. eCollection 2021.
The thoracic aorta is a highly mobile organ whose dynamics are altered by thoracic endovascular aorta repair (TEVAR). The aim of this study was to quantify cardiac pulsatility-induced multi-axial deformation of the thoracic aorta before and after descending aortic TEVAR.
Eleven TEVAR patients (8 males and 3 females, age 57-89) underwent retrospective cardiac-gated CT angiography before and after TEVAR. 3D geometric models of the thoracic aorta were constructed, and lumen centerlines, inner and outer surface curves, and cross-sections were extracted to measure aortic arclength, centerline, inner surface, and outer surface longitudinal curvatures, as well as cross-sectional effective diameter and eccentricity for the ascending and stented aortic portions.
From pre- to post-TEVAR, arclength deformation was increased at the ascending aorta from 5.9 ± 3.1 % to 8.8 ± 4.4 % (P < 0.05), and decreased at the stented aorta from 7.5 ± 5.1 % to 2.7 ± 2.5 % (P < 0.05). Longitudinal curvature and diametric deformations were reduced at the stented aorta. Centerline curvature, inner surface curvature, and cross-sectional eccentricity deformations were increased at the distal ascending aorta.
Deformations were reduced in the stented thoracic aorta after TEVAR, but increased in the ascending aorta near the aortic arch, possibly as a compensatory mechanism to maintain overall thoracic compliance in the presence of reduced deformation in the stiffened stented aorta.
胸主动脉是一个高度可移动的器官，其动力学在胸主动脉腔内修复术（TEVAR）后会发生改变。本研究的目的是量化降主动脉TEVAR术前和术后心脏搏动引起的胸主动脉多轴变形。
11例TEVAR患者（8例男性，3例女性，年龄57 - 89岁）在TEVAR术前和术后接受了回顾性心脏门控CT血管造影。构建胸主动脉的三维几何模型，并提取管腔中心线、内表面和外表面曲线以及横截面，以测量升主动脉和带支架主动脉部分的主动脉弧长、中心线、内表面和外表面纵向曲率，以及横截面有效直径和偏心率。
从TEVAR术前到术后，升主动脉的弧长变形从5.9±3.1%增加到8.8±4.4%（P<0.05），带支架主动脉的弧长变形从7.5±5.1%减少到2.7±2.5%（P<0.05）。带支架主动脉的纵向曲率和直径变形减小。升主动脉远端的中心线曲率、内表面曲率和横截面偏心率变形增加。
TEVAR术后带支架的胸主动脉变形减小，但主动脉弓附近的升主动脉变形增加，这可能是一种代偿机制，以在僵硬的带支架主动脉变形减少的情况下维持整体胸部顺应性。
