title: Impact of endografting on the thoracic aortic anatomy: comparative analysis of the aortic geometry before and after the endograft implantation.
abstract: OBJECTIVE
  Although the widespread acceptance of thoracic endovascular aortic repair (TEVAR) as a first-line treatment option for a multitude of thoracic aortic diseases, little is known about the consequences of the device implantation on the native aortic anatomy. We propose a comparative analysis of the pre- and postoperative geometry on a clinical series of patients and discuss the potential clinical implications
  
  
  METHODS
  CT pre- and postoperative acquisitions of 30 consecutive patients treated by TEVAR for different pathologies (20 thoracic aortic aneurysms, 6 false aneurysms, 3 penetrating ulcers, 1 traumatic rupture) were used to model the vascular geometry. Pre- and postoperative geometries were compared for each patient by pairing and matching the 3D models. An implantation site was identified, and focal differences were detected and described.
  
  
  RESULTS
  Segmentation of the data sets was successfully performed for all 30 subjects. Geometry differences between the pre- and postoperative meshes were depicted in 23 patients (76 %). Modifications at the upper implantation site were detected in 14 patients (47 %), and among them, the implantation site involved the arch (Z0-3) in 11 (78 %).
  
  
  CONCLUSIONS
  Modeling the vascular geometry on the basis of imaging data offers an effective tool to perform patient-specific analysis of the vascular geometry before and after the treatment. Future studies will evaluate the consequences of these changes on the aortic function.
authors.affiliation: Cardiovascular and Interventional Radiology, University Hospital of Lille, Lille, France, marco.midulla@chru-lille.fr.
authors.forename: Marco
authors.initials: M
authors.lastname: Midulla
authors.forename: Ramiro
authors.initials: R
authors.lastname: Moreno
authors.forename: Anne
authors.initials: A
authors.lastname: Negre-Salvayre
authors.forename: Franc
authors.initials: F
authors.lastname: Nicoud
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Pruvo
authors.forename: Stephan
authors.initials: S
authors.lastname: Haulon
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome