Importance of dynamic aortic evaluation in planning TEVAR
Guido H W van Bogerijen1, Joost A van Herwaarden1, Michele Conti1
11 Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands ; 2 Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Italy ; 3 Department of Civil Engineering and Architecture, Structural Mechanics Division, University of Pavia, Italy.
Annals of Cardiothoracic Surgery
|June 27, 2014
Summary
Dynamic imaging improves thoracic endovascular aortic repair (TEVAR) planning by ensuring accurate stent graft sizing. This approach helps prevent complications and enhances patient outcomes in aortic repair procedures.
Area of Science:
- Medical Imaging
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Static imaging protocols for thoracic endovascular aortic repair (TEVAR) planning do not account for normal aortic dynamics.
- This can result in stent graft to aorta mismatch, leading to complications like type I endoleak and stent graft migration.
Purpose of the Study:
- To highlight the importance of dynamic aortic evaluation in TEVAR planning.
- To discuss the role of advanced imaging modalities in improving stent graft selection, sizing, and follow-up.
- To emphasize the interdisciplinary approach needed for developing new imaging technologies.
Main Methods:
- Review of dynamic imaging modalities including electrocardiographic-gated computed tomography angiography (ECG-gated CTA) and four-dimensional phase-contrast MRI (4D PC-MRI).
- Discussion of the integration of engineering, informatics, and medicine for technological advancement.
Main Results:
- Dynamic imaging enables accurate preoperative stent graft selection and sizing.
- It aids in evaluating stent graft performance during postoperative follow-up.
- These techniques are increasingly implemented in clinical practice for TEVAR.
Conclusions:
- Dynamic imaging represents a significant advancement in the evaluation of the thoracic aorta for TEVAR.
- Further application of these tools is expected to improve patient outcomes.
- Interdisciplinary collaboration is key to future innovations in this field.
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