Dynamic cine-computed tomography angiography imaging of standard and fenestrated endografts: differing effects on renal artery motion.
Different endograft configurations (fenestrated, transrenal, infrarenal) may varyingly affect aortic side branch movement. Renal artery motion was evaluated with 64-slice dynamic cine-computed tomography angiography before and after endovascular aneurysm repair in 16 patients (46 renal arteries). Center-of-mass displacement of the renals was determined per heartbeat for before repair for 3 different endografts; differences were compared, with significance at P < 0.5. Preoperative renal artery motion is significant (1.2 [SD 0.5] mm, range, 0.6-2.). Neither transrenal nor infrarenal endografts alter renal artery motion compared with before repair (P < .05). Renal artery motion after fenestrated endovascular repair with renal stents reduces motion to 25% of the preoperative value (0.3 [SD, 0.1] mm, range, 0.2-0.5 mm; P = .01). Endograft implantation without stented side branches does not change renal artery motion, potentially allowing significant movement of the renal artery relative to the fenestration. Routine stenting of fenestrations limits postoperative renal artery motion to 0.3 mm, thereby preventing significant branch movement in relation the fenestration.
Muhs
Bart E
BE
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Vincken
Koen L
KL
Teutelink
Arno
A
Verhoeven
Eric L G
EL
Prokop
Matthias
M
Moll
Frans L
FL
Verhagen
Hence J M
HJ
D000704:Analysis of Variance; D000792:Angiography / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D003287:Contrast Media; D005240:Feasibility Studies; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D009038:Motion; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000502:physiology*; D015607:Stents; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency; D014741:Video Recording
D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol