High wall stress may predict the formation of stent-graft-induced new entries after thoracic endovascular aortic repair
File(s)Menichini et al accepted version.pdf (375.48 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
PURPOSE: To explore the potential role of morphological factors and wall stress in the formation of stent-graft-induced new entries (SINE) based on computed tomography (CT) images after thoracic endovascular aortic repair (TEVAR). CASE REPORT: Two female patients aged 59 years (patient 1) and 44 years (patient 2) underwent TEVAR for type B dissection in the chronic (patient 1) or subacute (patient 2) phase. CT scans at 3-month follow-up showed varying degrees of false lumen thrombosis in both patients. At 14-month follow-up, a SINE was observed in patient 1 while the dissected aorta in the other patient remained stable. Morphological and finite element analyses were performed based on the first follow-up CT images. The computational results showed that the SINE patient had higher stent-graft tortuosity than the non-SINE patient and much higher wall stress in the region close to the distal SINE. CONCLUSION: This case study suggests that high stent-graft tortuosity can lead to high wall stress, which is potentially linked to the formation of SINE. Further large population-based studies are needed to confirm this preliminary finding.
Date Issued
2018-10
Date Acceptance
2018-05-17
Citation
Journal of Endovascular Therapy, 2018, 25 (5), pp.571-577
ISSN
1526-6028
Publisher
SAGE Publications
Start Page
571
End Page
577
Journal / Book Title
Journal of Endovascular Therapy
Volume
25
Issue
5
Copyright Statement
© 2018 The Author(s). The final, definitive version of this paper has been published in Journal of Endovascular Therapy, Vol 25, Issue 5, pp. 571 - 577, by Sage Publications Ltd. All rights reserved. It is available at: https://dx.doi.org/10.1177/1526602818791827
Sponsor
Commission of the European Communities
Imperial College Healthcare Charity
The Royal Society
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30056791
Grant Number
642458
N/A
IE161052
Subjects
aortic dissection
finite element analysis
new entry tears
stent-graft
stent-graft–induced new entries
thoracic endovascular aortic repair
type B dissection
wall stress
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2018-07-30