In Vivo MR Angiographic Quantification of Axial and Twisting Deformations of the Superficial Femoral Artery Resulting from Maximum Hip and Knee Flexion

Cheng, Christopher P.; Wilson, Nathan M.; Hallett, Richard L.; Herfkens, Robert J.; Taylor, Charles A.

doi:10.1097/01.rvi.0000220367.62137.e8

Cited by 150 publications

(116 citation statements)

References 12 publications

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“…Another limitation concerns the limited number of patients included; however, the typical number of subjects in similar work is between 1 and a maximum of 10. [12][13][14]17,18 In addition, the patients considered in this study covered a large range of arterial calcifications, which is sufficient to provide an assessment of the effect of the PAD on the arterial deformations.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15][16][17][18] Although these studies provided important information concerning arterial deformations occurring during various activities, they mostly considered young 12,17 and healthy subjects, 14,18 and subjects with only mild or non-calcified arteries. 13 To our knowledge, the present study is the only one on subjects with clinically relevant PAD; however, the general arterial behavior during the flexion measured in the present work is consistent with previous observations.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the difficulties arising from in-vivo measurement of mechanical forces, previous studies concerned with this characterization focused on the quantification of in-vivo arterial deformations. [12][13][14][15][16][17][18] Although the improvements with each new study are evident, there are certain limitations that may affect their results; namely the use of cadavers 15,16 , young 12,17 and healthy subjects, 14,18 and subjects with only mildly or non-calcified arteries. 13 To our knowledge, no data is available concerning arterial deformations in patients with clinically relevant PAD.…”

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confidence: 99%

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Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study

Gökgöl

Diehm

Kara

et al. 2013

Journal of Endovascular Therapy

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Purpose: To quantify the in-vivo deformations of the popliteal arterial segment (PAS) during leg flexion in subjects with clinically relevant (Fontaine Stage IIb) peripheral arterial disease (PAD).Methods: Five patients with varying calcification levels of the PAS undergoing endovascular revascularization underwent 3D rotational angiography. Image acquisition was performed with the leg straight and with a flexion of 70°/20° in the knee/hip joint. The arterial centerline and the corresponding branches in both positions were segmented to create 3D reconstructions of the arterial trees. Axial deformation, twisting, and curvatures were quantified. Furthermore, the relationships between the calcification levels and the deformations were investigated. Results:We observed an average shortening of the PAS of 5.9% ± 2.5% and twist rate of 3.8 Conclusions:The PAS of patients with symptomatic PAD is exposed to significant deformations during flexion of the knee joint. The curvature is directly affected by the extent of arterial calcification. In contrast, the changes in arterial length and twisting angles are comparable to those of healthy arteries. These measurements have the potential to be used for realistic arterial modeling to improve stent designs.This study also showed the ability of rotational angiography to quantify the three-dimensional deformations of the PAS in patients with various levels of calcification, and that this technique can be used to collect data on larger groups of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study

Gökgöl

Diehm

Kara

et al. 2013

Journal of Endovascular Therapy

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“…1 Magnetic resonance angiography studies demonstrated 13% shortening of the SFA between supine and fetal positions. 2 There are 60° of SFA torsion produced by simultaneous knee and hip flexion. 2 Given these anatomic and dynamic challenges, it is hardly surprising that treatment strategies for established FP atherosclerosis suffer from marked limitations.…”

Section: Response By Garcia On P 329mentioning

confidence: 99%

Drug-Eluting Stents Are the Default Strategy for Superficial Femoral Artery Intervention Now

Burket

2016

Circulation

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“…A recent study [9] summarized the historical values of these deformations, data largely based on the analysis of in vivo three-dimensional measurements with magnetic resonance imaging (MRI) [17,18] and angiography with threedimensional modelling [19]. The three-dimensional nature of MRI allows accurate assessment of arterial bending with limb flexion, and use of large side branches allows quantification of torsion.…”

Section: Introductionmentioning

confidence: 99%

Limb flexion-induced twist and associated intramural stresses in the human femoropopliteal artery

Desyatova

Poulson

Deegan

et al. 2017

J. R. Soc. Interface.

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High failure rates of femoropopliteal artery (FPA) interventions are often attributed to severe mechanical deformations that occur with limb movement. Torsion of the FPA likely plays a significant role, but is poorly characterized and the associated intramural stresses are currently unknown. FPA torsion in the walking, sitting and gardening postures was characterized in n ¼ 28 in situ FPAs using intra-arterial markers. Principal mechanical stresses and strains were quantified in the superficial femoral artery (SFA), adductor hiatus segment (AH) and the popliteal artery (PA) using analytical modelling. The FPA experienced significant torsion during limb flexion that was most severe in the gardening posture. The associated mechanical stresses were non-uniformly distributed along the length of the artery, increasing distally and achieving maximum values in the PA. Maximum twist in the SFA ranged 10-138 cm 21, at the AH 8-168 cm 21, and in the PA 14-268 cm 21 in the walking, sitting and gardening postures. Maximum principal stresses were 30-35 kPa in the SFA, 27-37 kPa at the AH and 39-43 kPa in the PA. Understanding torsional deformations and intramural stresses in the FPA can assist with device selection for peripheral arterial disease interventions and may help guide the development of devices with improved characteristics.

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In Vivo MR Angiographic Quantification of Axial and Twisting Deformations of the Superficial Femoral Artery Resulting from Maximum Hip and Knee Flexion

Cited by 150 publications

References 12 publications

Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study

Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study

Drug-Eluting Stents Are the Default Strategy for Superficial Femoral Artery Intervention Now

Limb flexion-induced twist and associated intramural stresses in the human femoropopliteal artery

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