Aortic Curvature Remodeling after Thoracic Endovascular Aortic Repair: Assessing Device Conformability, Using Image...

Area of Science:

• Vascular Surgery
• Medical Imaging Analysis
• Biomedical Engineering

Background:

• Aortic arch curvature can be altered by endograft placement.
• Previous studies used varied methods and devices for aortic arch analysis.
• This study evaluates the Conformable Gore TAG Thoracic Endoprosthesis pliability in the aortic arch.

Purpose of the Study:

• To assess the aortic arch pliability of the Conformable Gore TAG Thoracic Endoprosthesis.
• To analyze aortic curvature changes using multiple image vector analysis methods.
• To determine endograft length predictability in the aortic arch.

Main Methods:

• Retrospective analysis of 37 patients treated with Conformable Gore TAG Thoracic Endoprosthesis (zones Z1-Z3).
• Computed tomography angiographies (CTAs) analyzed at preoperative, 1-month, and 6-month follow-ups.
• Three image analysis methods used: segment analysis, center lumen line analysis, and expected behavior (device length).

Main Results:

• Minimal changes in aortic curvature observed via segment and center lumen line analysis at 6 months.
• Negligible straightening of aortic curvature noted at 1 month, resolving by 6 months.
• High predictability of endograft length (ICC > 0.994) and no significant differences based on proximal sealing location.

Conclusions:

• The Conformable Gore TAG Thoracic Endoprosthesis exhibits good pliability in the aortic arch and proximal thoracic aorta.
• Minimal short-term changes in aortic curvature were observed post-endograft placement.
• Endograft length within the outer aortic curvature is highly predictable.