Morphological changes and device migration after stent graft insertion ― Clinical application of an image-based modeling system and analysis with geometric parameters

Youkou Nemoto, Katsuyuki Hoshina, Masaharu Kobayashi, Masaru Kimura, Sota Yamamoto, Toshiaki Watanabe, Marie Ohshima

Research output: Contribution to journalArticle

Abstract

Background: Previously, we developed an image-based modeling system (V-Modeler) to investigate geometric changes in stent grafts (SGs) following their implantation for abdominal aortic aneurysms (AAAs). The aims of the present study were to improve this system for clinical use, to chronologically analyze postoperative morphological changes in SGs, and to demonstrate scenarios of SG migration. Methods and Results: Contrast-enhanced computed tomography data from 36 patients who underwent endovascular aneurysm repair (EVAR) for AAAs were used, with 72 centerline paths, in total, analyzed for bilateral SG legs. The existing V-modeler system was modified by introducing a penalty term, optimizing the number of control points using Akaike’s information criterion, and changing the degree of the function from 3 to 5. Geometric parameters were then analyzed immediately, as well as >1 year after EVAR. Eight migrations were found and although overall SG curvature and curvature at the distal (leg) site did not change, curvature at the proximal (trunk) site of SGs decreased over time. Subanalysis revealed that SGs with severe curvature showed the same trend, whereas distal curvature increased in the non-severe curvature group. In addition, proximal curvature decreased more in Excluder than Zenith devices. Conclusions: The present study demonstrates SG behavior after implantation with numerical values for SG length and curvature.

Original languageEnglish
Pages (from-to)176-182
Number of pages7
JournalCirculation Journal
Volume82
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

Keywords

  • Abdominal aortic aneurysm
  • Imaging
  • Modeling
  • Stent graft

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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