Abstract
OBJECTIVES: To quantify the impact of thoracic endovascular aortic repair (TEVAR) on radial aortic strain with the aim of elucidating stent-graft-induced stiffening and complications. METHODS: Twenty fresh thoracic porcine aortas were connected to a mock circulatory loop driven by a centrifugal flow pump. A highdefinition camera captured diameters at five different pressure levels (100, 120, 140, 160, and 180 mmHg), before and after TEVAR. Three oversizing groups were created: 0-9% (n = 7), 10-19% (n = 6), and 20-29% (n = 6). Radial strain (or deformation) derived from diameter amplitude divided by baseline diameter at 100 mmHg. Uniaxial tensile testing evaluated Young's moduli of the specimens. RESULTS: Radial strain was reduced after TEVAR within the stented segment by 49.4 ± 24.0% (P < 0.001). As result, a strain mismatch was observed between the stented segment and the proximal non-stented segment (7.0 ± 2.5% vs 11.8 ± 3.9%, P < 0.001), whereas the distal non-stented segment was unaffected (P = 0.99). Stent-graft oversizing did not significantly affect the amount of strain reduction (P = 0.30). Tensile testing showed that the thoracic aortas tended to be more elastic proximally than distally (P = 0.11). CONCLUSIONS: TEVAR stiffened the thoracic aorta by 2-fold. Such segmental stiffening may diminish the Windkessel function considerably and might be associated with TEVAR-related complications, including stent-graft-induced dissection and aneurysmal dilatation. These data may have implications for future stent-graft design, in particular for TEVAR of the highly compliant proximal thoracic aorta.
| Original language | English |
|---|---|
| Article number | ezw369 |
| Pages (from-to) | 783-789 |
| Number of pages | 7 |
| Journal | European Journal of Cardio-thoracic Surgery |
| Volume | 51 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 1 2017 |
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Keywords
- Aortic strain
- Stent-graft
- TEVAR
- Thoracic aorta
- Uniaxial tensile testing
ASJC Scopus subject areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine
Cite this
Impact of thoracic endovascular aortic repair on radial strain in an ex vivo porcine model. / Nauta, Foeke J.H.; de Beaufort, Hector W.L.; Conti, Michele; Marconi, Stefania; Kamman, Arnoud V.; Ferrara, Anna; van Herwaarden, Joost A.; Moll, Frans L.; Auricchio, Ferdinando; Trimarchi, Santi.
In: European Journal of Cardio-thoracic Surgery, Vol. 51, No. 4, ezw369, 01.04.2017, p. 783-789.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of thoracic endovascular aortic repair on radial strain in an ex vivo porcine model
AU - Nauta, Foeke J.H.
AU - de Beaufort, Hector W.L.
AU - Conti, Michele
AU - Marconi, Stefania
AU - Kamman, Arnoud V.
AU - Ferrara, Anna
AU - van Herwaarden, Joost A.
AU - Moll, Frans L.
AU - Auricchio, Ferdinando
AU - Trimarchi, Santi
PY - 2017/4/1
Y1 - 2017/4/1
N2 - OBJECTIVES: To quantify the impact of thoracic endovascular aortic repair (TEVAR) on radial aortic strain with the aim of elucidating stent-graft-induced stiffening and complications. METHODS: Twenty fresh thoracic porcine aortas were connected to a mock circulatory loop driven by a centrifugal flow pump. A highdefinition camera captured diameters at five different pressure levels (100, 120, 140, 160, and 180 mmHg), before and after TEVAR. Three oversizing groups were created: 0-9% (n = 7), 10-19% (n = 6), and 20-29% (n = 6). Radial strain (or deformation) derived from diameter amplitude divided by baseline diameter at 100 mmHg. Uniaxial tensile testing evaluated Young's moduli of the specimens. RESULTS: Radial strain was reduced after TEVAR within the stented segment by 49.4 ± 24.0% (P < 0.001). As result, a strain mismatch was observed between the stented segment and the proximal non-stented segment (7.0 ± 2.5% vs 11.8 ± 3.9%, P < 0.001), whereas the distal non-stented segment was unaffected (P = 0.99). Stent-graft oversizing did not significantly affect the amount of strain reduction (P = 0.30). Tensile testing showed that the thoracic aortas tended to be more elastic proximally than distally (P = 0.11). CONCLUSIONS: TEVAR stiffened the thoracic aorta by 2-fold. Such segmental stiffening may diminish the Windkessel function considerably and might be associated with TEVAR-related complications, including stent-graft-induced dissection and aneurysmal dilatation. These data may have implications for future stent-graft design, in particular for TEVAR of the highly compliant proximal thoracic aorta.
AB - OBJECTIVES: To quantify the impact of thoracic endovascular aortic repair (TEVAR) on radial aortic strain with the aim of elucidating stent-graft-induced stiffening and complications. METHODS: Twenty fresh thoracic porcine aortas were connected to a mock circulatory loop driven by a centrifugal flow pump. A highdefinition camera captured diameters at five different pressure levels (100, 120, 140, 160, and 180 mmHg), before and after TEVAR. Three oversizing groups were created: 0-9% (n = 7), 10-19% (n = 6), and 20-29% (n = 6). Radial strain (or deformation) derived from diameter amplitude divided by baseline diameter at 100 mmHg. Uniaxial tensile testing evaluated Young's moduli of the specimens. RESULTS: Radial strain was reduced after TEVAR within the stented segment by 49.4 ± 24.0% (P < 0.001). As result, a strain mismatch was observed between the stented segment and the proximal non-stented segment (7.0 ± 2.5% vs 11.8 ± 3.9%, P < 0.001), whereas the distal non-stented segment was unaffected (P = 0.99). Stent-graft oversizing did not significantly affect the amount of strain reduction (P = 0.30). Tensile testing showed that the thoracic aortas tended to be more elastic proximally than distally (P = 0.11). CONCLUSIONS: TEVAR stiffened the thoracic aorta by 2-fold. Such segmental stiffening may diminish the Windkessel function considerably and might be associated with TEVAR-related complications, including stent-graft-induced dissection and aneurysmal dilatation. These data may have implications for future stent-graft design, in particular for TEVAR of the highly compliant proximal thoracic aorta.
KW - Aortic strain
KW - Stent-graft
KW - TEVAR
KW - Thoracic aorta
KW - Uniaxial tensile testing
UR - http://www.scopus.com/inward/record.url?scp=85017337232&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85017337232&partnerID=8YFLogxK
U2 - 10.1093/ejcts/ezw393
DO - 10.1093/ejcts/ezw393
M3 - Article
C2 - 28043989
AN - SCOPUS:85017337232
VL - 51
SP - 783
EP - 789
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 4
M1 - ezw369
ER -