Detection of endograft fractures with multidetector row computed tomography

Roos, Justus E.; Hellinger, Jeffrey C.; Hallet, Richard; Fleischmann, Dominik; Zarins, Christopher K.; Rubin, Geoffrey D.

doi:10.1016/j.jvs.2005.07.009

Cited by 23 publications

(16 citation statements)

References 21 publications

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“…13 Late stent graft failure is a serious complication in endovascular repair of aortic aneurysms. [14][15][16][17] Better understanding of the motion characteristics of stent grafts will be beneficial for designing future devices. In addition, these data can be valuable in predicting stent graft failure in patients.…”

Section: Introductionmentioning

confidence: 99%

Detectability of motions in AAA with ECG‐gated CTA: A quantitative study

et al. 2009

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Section: Introductionmentioning

confidence: 99%

Detectability of motions in AAA with ECG‐gated CTA: A quantitative study

et al. 2009

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“…Owing to the greater complexity of predeployment planning, the limited ability of peri-procedural imaging to assess for robust proximal and distal seals as well as back-bleeding into the aneurysm sac from patent branches and the possibility over time for dislodgment and disintegration of the stent-graft, the necessity for postdeployment surveillance was greater than with conventional repair. In clinical trials of endografts, the combination of conventional angiography and projectional radiography were established as the imaging standard for identifying endoleaks and device displacement, however, CT angiography quickly emerged as a superior modality for endoleak detection (67,68) and ultimately for the detection of stent-graft migration and disintegration, as well (Fig 9) (69). The former observation was based on the elimination of overlapping structures owing to the cross-sectional acquisition and the greater sensitivity of CT for low concentrations of iodine, which for endoleak detection may be subjected to intraarterial dilution prior to entering the sac via collateral pathways with distant origins (70).…”

Section: Endovascular Aortic Repairmentioning

confidence: 99%

CT Angiography after 20 Years: A Transformation in Cardiovascular Disease Characterization Continues to Advance

et al. 2014

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Through a marriage of spiral computed tomography (CT) and graphical volumetric image processing, CT angiography was born 20 years ago. Fueled by a series of technical innovations in CT and image processing, over the next 5–15 years, CT angiography toppled conventional angiography, the undisputed diagnostic reference standard for vascular disease for the prior 70 years, as the preferred modality for the diagnosis and characterization of most cardiovascular abnormalities. This review recounts the evolution of CT angiography from its development and early challenges to a maturing modality that has provided unique insights into cardiovascular disease characterization and management. Selected clinical challenges, which include acute aortic syndromes, peripheral vascular disease, aortic stent-graft and transcatheter aortic valve assessment, and coronary artery disease, are presented as contrasting examples of how CT angiography is changing our approach to cardiovascular disease diagnosis and management. Finally, the recently introduced capabilities for multispectral imaging, tissue perfusion imaging, and radiation dose reduction through iterative reconstruction are explored with consideration toward the continued refinement and advancement of CT angiography.

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“…Depending on the type of stent graft and the location of the fracture, this may have serious consequences. 10,11 Conversion to resolve failing EVAR is accompanied by a substantial morbidity and mortality 12 and FEVAR in a failed EVAR device is complex and may lead to technical failure because of the inability to cannulate the side branches. 13 Failure of EVAR may occur years after treatment.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Stent Graft Motion in ECG Gated CT by Image Registration and Segmentation: In Vitro Validation and Preliminary Clinical Results

Koenrades

Struijs

Klein³

et al. 2019

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS The present article establishes a novel method to quantify and visualise stent graft motion in multiphasic ECG gated computed tomography using image registration techniques. In vitro validation demonstrated adequate accuracy for quantifying abdominal aortic stent graft displacement. The methodology was successfully applied to clinical data of patients treated by endovascular aneurysm repair (EVAR) with different stent graft designs. This novel methodology enables provision of accurate data characterising the in situ motions of stent grafts in the endovascular environment. This may have a major impact on stent graft design and early prediction of failure in post-market evaluations of new or modified devices.Objectives: The dynamic endovascular environment of stent grafts may influence long term outcome after endovascular aneurysm repair (EVAR). The sealing and fixation of a stent graft to the aortic wall is challenged at every heartbeat, yet knowledge of the cardiac induced dynamics of stent grafts is sparse. Understanding the stenteartery interaction is crucial for device development and may aid the prediction of failure in the individual patient. The aim of this work was to establish quantitative stent graft motion in multiphasic electrocardiogram (ECG) gated computed tomography (CT) by image registration and segmentation techniques. Methods: Experimental validation was performed by evaluating a series of ECG gated CT scans of a stent graft moving at different amplitudes of displacement at different virtual heart rates using a motion generating device with synchronised ECG triggering. The methodology was further tested on clinical data of patients treated with EVAR devices with different stent graft designs. Displacement during the cardiac cycle was analysed for points on the fixating stent rings, the branches or fenestrations, and the spine. Results: Errors for the amplitude of displacement measured in vitro at individual points on the wire frame were at most 0.3 mm. In situ cardiac induced displacement of the devices was found to differ per location and also depended on the type of stent graft. Displacement during the cardiac cycle was greatest in a fenestrated device and smallest in a chimney graft sac anchoring endosystem, with maximum displacement varying from 0.0 to 1.4 mm. There was no substantial displacement measurable in the spine. Conclusions: A novel methodology to quantify and visualise stent graft motion in multiphasic ECG gated CT has been validated in vitro and tested in vivo. This methodology enables further exploration of in situ motion of different stent grafts and branch stents and their interaction with native vessels.

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Detection of endograft fractures with multidetector row computed tomography

Cited by 23 publications

References 21 publications

Detectability of motions in AAA with ECG‐gated CTA: A quantitative study

Detectability of motions in AAA with ECG‐gated CTA: A quantitative study

CT Angiography after 20 Years: A Transformation in Cardiovascular Disease Characterization Continues to Advance

Quantitative Stent Graft Motion in ECG Gated CT by Image Registration and Segmentation: In Vitro Validation and Preliminary Clinical Results

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