Shortest Apposition Length at the First Postoperative Computed Tomography Angiography Identifies Patients at Risk for Developing a Late Type Ia Endoleak After Endovascular Aneurysm Repair

Geraedts, Anna C. M.; Zuidema, Roy; Schuurmann, Richte C. L.; Kwant, Ayla N.; Mulay, Sana; Balm, Ron; Vries, Jean‐Paul P.M. de

doi:10.1177/15266028221120514

Cited by 9 publications

(16 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Inclusion criteria were based on a previous study by this research group regarding apposition on the first postoperative CTA, with largely the same patients [ 13 ]. The late T1aEL group included patients with a first post-EVAR CTA (<90 days post-EVAR) without a type 1 (or type 3) endoleak, who developed a T1aEL thereafter.…”

Section: Methodsmentioning

confidence: 99%

“…All CTAs were analysed in 3mensio 10.1 software (Pie Medical Imaging BV, Maastricht, The Netherlands). The entire CTA measurement protocol has been published [ 13 ]. On each preoperative CTA, the neck diameter, intended oversizing, neck length, infrarenal/suprarenal angulation, neck thrombus, neck calcification, neck shape, and maximum aneurysm diameter were measured.…”

Section: Methodsmentioning

confidence: 99%

“…All postoperative endograft dimensions were calculated in VIA software (Endovascular Diagnostics BV, Utrecht, The Netherlands) using the centreline, aortic mesh, and three-dimensional coordinates, according to previously published and validated methods [ 9 , 10 , 13 ]. The primary endpoint, the real achieved sealing zone, was defined as the length starting at the proximal end of the endograft fabric and over which the endograft material has proper circumferential apposition with the aortic wall [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

“…SAL was defined as the shortest length between the proximal end of the endograft fabric to the first level where the endograft lost circumferential apposition with the aortic wall [ 9 ]. Patients will be classified as high risk when the SAL is <10 mm, based on the existing literature and device instructions for use [ 13 , 15 , 16 ]. The SAL/aortic neck length ratio, shortest fabric distance, and endograft expansion were also calculated.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Diminishing Endograft Apposition during Follow-Up Is an Important Indicator of Late Type 1a Endoleak after Endovascular Aneurysm Repair

Zuidema

Geraedts

Veldhuizen

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

Late type 1a endoleaks (T1aELs) after endovascular aneurysm repair (EVAR) are hazardous complications which should be avoided. This study investigated the evolution of the shortest apposition length (SAL) post-EVAR and hypothesised that a declining apposition during follow-up may be an indicator of T1aEL development. Patients with a late T1aEL were selected from a consecutive multicentre database. For each T1aEL patient, the preoperative computed tomography angiography (CTA), first postoperative CTA, and pre-endoleak CTA were analysed. T1aEL patients were matched 1:1 to uncomplicated controls, based on endograft type and follow-up duration. Anatomical characteristics and endograft dimensions, including the post-EVAR SAL, were measured. Included were 28 patients with a late T1aEL and 28 matched controls. The SAL decreased from 11.2 mm (5.6–20.6 mm) to 3.9 mm (0.0–11.4 mm) in the T1aEL group (p = 0.006), whereas an increase in SAL was seen in the control group from 21.3 mm (14.1–25.8 mm) to 25.4 mm (19.0–36.2 mm; p = 0.015). On the pre-endoleak CTA, 18 patients (64%) in the T1aEL group had a SAL < 10 mm, and one (4%) patient in the control group had a SAL < 10 mm on the matched CTAs. Moreover, three mechanisms of decreasing sealing zone were identified, which might be used to determine optimal imaging or reintervention strategies. Diminishing SAL < 10 mm is an indicator for T1aEL during follow-up, it is imperative to include apposition analysis during follow-up.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Diminishing Endograft Apposition during Follow-Up Is an Important Indicator of Late Type 1a Endoleak after Endovascular Aneurysm Repair

Zuidema

Geraedts

Veldhuizen

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…The T1aEL group was composed of patients from 2 previous studies, to include a sufficiently large number of patients with a T1aEL. 19,20 These patients were treated between 2005 and 2017 in the St. Antonius Hospital, Nieuwegein (n=10), Royal Oldham Hospital, Manchester (n=2), and Catharina Hospital, Eindhoven (n=10). Fortyone patients originated from the ODYSSEUS study group (Figure 1).…”

Section: Study Populationmentioning

confidence: 99%

A Statistical Shape Model of Infrarenal Aortic Necks in Patients With and Without Late Type Ia Endoleak After Endovascular Aneurysm Repair

et al. 2023

Self Cite

View full text Add to dashboard Cite

Purpose: Hostile aortic neck characteristics, including short length, severe suprarenal and infrarenal angulation, conicity, and large diameter, have been associated with increased risk for type Ia endoleak (T1aEL) after endovascular aneurysm repair (EVAR). This study investigates the mid-term discriminative ability of a statistical shape model (SSM) of the infrarenal aortic neck morphology compared with or in combination with conventional measurements in patients who developed T1aEL post-EVAR. Materials and Methods: The dataset composed of EVAR patients who developed a T1aEL during follow-up and a control group without T1aEL. Principal component (PC) analysis was performed using a parametrization to create an SSM. Three logistic regression models were created. To discriminate between patients with and without T1aEL, sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve (AUC) were calculated. Results: In total, 126 patients (84% male) were included. Median follow-up time in T1aEl group and control group was 52 (31, 78.5) and 51 (40, 62.5) months, respectively. Median follow-up time was not statistically different between the groups (p=0.72). A statistically significant difference between the median PC scores of the T1aEL and control groups was found for the first, eighth, and ninth PC. Sensitivity, specificity, and AUC values for the SSM-based versus the conventional measurements–based logistic regression models were 79%, 70%, and 0.82 versus 74%, 73%, and 0.85, respectively. The model of the SSM and conventional measurements combined resulted in sensitivity, specificity, and AUC of 81%, 81%, and 0.92. Conclusion: An SSM of the infrarenal aortic neck determines its 3-dimensional geometry. The SSM is a potential valuable tool for risk stratification and T1aEL prediction in EVAR. The SSM complements the conventional measurements of the individual preoperative infrarenal aortic neck geometry by increasing the predictive value for late type Ia endoleak after standard EVAR. Clinical Impact A statistical shape model (SSM) determines the 3-dimensional geometry of the infrarenal aortic neck. The SSM complements the conventional measurements of the individual pre-operative infrarenal aortic neck geometry by increasing the predictive value for late type Ia endoleaks post-EVAR. The SSM is a potential valuable tool for risk stratification and late T1aEL prediction in EVAR and it is a first step toward implementation of a treatment planning support tool in daily clinical practice.

show abstract

Machine Learning Based Prediction of Post-operative Infrarenal Endograft Apposition for Abdominal Aortic Aneurysms

van Veldhuizen,

de Vries,

Tuinstra

et al. 2024

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

Shortest Apposition Length at the First Postoperative Computed Tomography Angiography Identifies Patients at Risk for Developing a Late Type Ia Endoleak After Endovascular Aneurysm Repair

Cited by 9 publications

References 22 publications

Diminishing Endograft Apposition during Follow-Up Is an Important Indicator of Late Type 1a Endoleak after Endovascular Aneurysm Repair

Diminishing Endograft Apposition during Follow-Up Is an Important Indicator of Late Type 1a Endoleak after Endovascular Aneurysm Repair

A Statistical Shape Model of Infrarenal Aortic Necks in Patients With and Without Late Type Ia Endoleak After Endovascular Aneurysm Repair

Machine Learning Based Prediction of Post-operative Infrarenal Endograft Apposition for Abdominal Aortic Aneurysms

Contact Info

Product

Resources

About