TY - JOUR
T1 - In Vivo Morphological Changes of the Femoropopliteal Arteries due to Knee Flexion After Endovascular Treatment of Popliteal Aneurysm
AU - Spinella, Giovanni
AU - Finotello, Alice
AU - Pane, Bianca
AU - Salsano, Giancarlo
AU - Mambrini, Simone
AU - Kamenskiy, Alexey
AU - Gazzola, Valerio
AU - Cittadini, Giuseppe
AU - Auricchio, Ferdinando
AU - Palombo, Domenico
AU - Conti, Michele
N1 - Funding Information:
The authors acknowledge Ana Jornea (University of Pavia) for her support in the analysis procedure. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Alexey Kamenskiy was supported in part by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) under Award Number R01 HL125736. In accordance with the NIH Public Access Policy, this article is available for open access at PubMed Central.
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Alexey Kamenskiy was supported in part by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) under Award Number R01 HL125736. In accordance with the NIH Public Access Policy, this article is available for open access at PubMed Central.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Purpose: To evaluate morphological changes of the femoropopliteal (FP) arteries due to limb flexion in patients undergoing endovascular treatment of popliteal artery aneurysms (PAAs). Materials and Methods: Seven male patients (mean age 68 years) underwent endovascular treatment of PAA with a Viabahn stent-graft between January 2013 and December 2017. During follow-up, one contrast-enhanced computed tomography angiography (CTA) scan of the lower limbs was acquired for each recruited patient. A standardized CTA protocol for acquisitions in both straight-leg and bent-leg positions was used to visualize changes in artery shape due to limb flexion. Three-dimensional reconstruction of the FP segment was performed to compute mean diameter and eccentricity of the vascular lumen and to measure length, tortuosity, and curvature of the vessel centerline in 3 arterial zones: (A) between the origin of the superficial femoral artery and the proximal end of the stent-graft, (B) within the stent-graft, and (C) from the distal end of the stent-graft to the origin of the anterior tibial artery. Results: After limb flexion, all zones of the FP segment foreshortened: 6% in zone A (p=0.001), 4% in zone B (p=0.001), and 8% in zone C (p=0.07), which was the shortest (mean 4.5±3.6 cm compared with 23.8±5.7 cm in zone A and 23.6±7.4 cm in zone B). Tortuosity increased in zone A (mean 0.03 to 0.05, p=0.03), in zone B (0.06 to 0.15, p=0.005), and in zone C (0.027 to 0.031, p=0.1). Mean curvature increased 15% (p=0.05) in zone A, 27% (p=0.005) in zone B, and 95% (p=0.06) in zone C. In all zones, the mean artery diameter and eccentricity were not significantly affected by limb flexion. Conclusion: Limb flexion induces vessel foreshortening and increases mean curvature and tortuosity of the FP segment both within and outside the area of the stent-graft.
AB - Purpose: To evaluate morphological changes of the femoropopliteal (FP) arteries due to limb flexion in patients undergoing endovascular treatment of popliteal artery aneurysms (PAAs). Materials and Methods: Seven male patients (mean age 68 years) underwent endovascular treatment of PAA with a Viabahn stent-graft between January 2013 and December 2017. During follow-up, one contrast-enhanced computed tomography angiography (CTA) scan of the lower limbs was acquired for each recruited patient. A standardized CTA protocol for acquisitions in both straight-leg and bent-leg positions was used to visualize changes in artery shape due to limb flexion. Three-dimensional reconstruction of the FP segment was performed to compute mean diameter and eccentricity of the vascular lumen and to measure length, tortuosity, and curvature of the vessel centerline in 3 arterial zones: (A) between the origin of the superficial femoral artery and the proximal end of the stent-graft, (B) within the stent-graft, and (C) from the distal end of the stent-graft to the origin of the anterior tibial artery. Results: After limb flexion, all zones of the FP segment foreshortened: 6% in zone A (p=0.001), 4% in zone B (p=0.001), and 8% in zone C (p=0.07), which was the shortest (mean 4.5±3.6 cm compared with 23.8±5.7 cm in zone A and 23.6±7.4 cm in zone B). Tortuosity increased in zone A (mean 0.03 to 0.05, p=0.03), in zone B (0.06 to 0.15, p=0.005), and in zone C (0.027 to 0.031, p=0.1). Mean curvature increased 15% (p=0.05) in zone A, 27% (p=0.005) in zone B, and 95% (p=0.06) in zone C. In all zones, the mean artery diameter and eccentricity were not significantly affected by limb flexion. Conclusion: Limb flexion induces vessel foreshortening and increases mean curvature and tortuosity of the FP segment both within and outside the area of the stent-graft.
KW - endovascular treatment
KW - femoropopliteal segment
KW - foreshortening
KW - limb flexion
KW - medical image analysis
KW - morphology
KW - popliteal artery aneurysm
KW - stent-graft
KW - superficial femoral artery
KW - tortuosity
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U2 - 10.1177/1526602819855441
DO - 10.1177/1526602819855441
M3 - Article
C2 - 31198084
AN - SCOPUS:85067948661
SN - 1526-6028
VL - 26
SP - 496
EP - 504
JO - Journal of Endovascular Therapy
JF - Journal of Endovascular Therapy
IS - 4
ER -