High Wall Stress May Predict the Formation of Stent-Graft–Induced New Entries After Thoracic Endovascular Aortic Repair. (October 2018)

• Record Type: Journal Article
• Authors: Menichini, Claudia; Pirola, Selene; Guo, Baolei; Fu, Weiguo; Dong, Zhihui; Xu, Xiao Yun
• Is Part Of: Journal of endovascular therapy. Volume 25:Number 5(2018:Oct.)
• Page Start: 571
• Page End: 577
• Publication Date: 2018-10
• 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; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602818791827
• Languages: English
• ISSNs: 1526-6028

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.