Simmering Jaimy A, van Helvert Majorie, van Herwaarden Joost A, Slump Cornelis H, Geelkerken Robert H, Reijnen Michel M P J
Department of Surgery, Division of Vascular Surgery, Medisch Spectrum Twente, 7512 KZ Enschede, The Netherlands.
Multi-Modality Medical Imaging (M3i) Group, Faculty of Science and Technology, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands.
Diagnostics (Basel). 2023 Jan 29;13(3):496. doi: 10.3390/diagnostics13030496.
To what extent the stentgraft design of iliac branch devices (IBDs) relates to dynamic deformation is currently unknown. Therefore, this study aimed to quantify and compare displacement and geometry changes during the cardiac cycle of two common IBDs. This paper presents a two-center trial with patients treated with a Zenith bifurcated iliac side (ZBIS) or Gore iliac branch endoprosthesis (IBE). All patients underwent a retrospective electrocardiogram (ECG)-gated computed tomographic angiography (CTA) during follow-up. Cardiac-pulsatility-induced displacement was quantified for the following locations: (neo) bifurcation of the aorta, IBD flow divider, distal markers of the internal iliac artery (IIA) component and first IIA bifurcation. Geometrical parameters (length, tortuosity index, curvature and torsion) were quantified over centerlines. Displacement was more pronounced for the IBE than the ZBIS, e.g., craniocaudal displacement of 0.91 mm (0.91-1.13 mm) vs. 0.57 mm (0.40-0.75 mm, = 0.004), respectively. The IBDs demonstrated similar geometrical parameters in the neo-common iliac artery and distal IIA, except for the larger dynamic curvature and torsion of the distal IIA in IBEs. The IBEs showed more dynamic length and curvature change compared to the ZBIS in the stented IIA. The IIA trajectory showed more pronounced deformation during the cardiac cycle after placement of an IBE than a ZBIS, suggesting the IBE is more conformable than the ZBIS.
目前尚不清楚髂支装置（IBD）的支架移植物设计与动态变形之间的关联程度。因此，本研究旨在量化和比较两种常见IBD在心动周期中的位移和几何形状变化。本文介绍了一项双中心试验，纳入了接受Zenith分叉髂侧（ZBIS）或戈尔髂支内支架（IBE）治疗的患者。所有患者在随访期间均接受了回顾性心电图（ECG）门控计算机断层血管造影（CTA）。对以下部位的心脏搏动性诱导位移进行了量化：主动脉（新）分叉处、IBD分流器、髂内动脉（IIA）组件的远端标记以及第一个IIA分叉处。通过中心线对几何参数（长度、扭曲指数、曲率和扭转）进行了量化。IBE的位移比ZBIS更明显，例如，头足向位移分别为0.91 mm（0.91 - 1.13 mm）和0.57 mm（0.40 - 0.75 mm， = 0.004）。在新的髂总动脉和远端IIA中，IBD显示出相似的几何参数，但IBE远端IIA的动态曲率和扭转更大。与ZBIS相比，IBE在带支架的IIA中显示出更大的动态长度和曲率变化。放置IBE后，IIA轨迹在心动周期中的变形比ZBIS更明显，表明IBE比ZBIS更贴合。
