title: Differences in aortic arch radius of curvature, neck size, and taper in patients with traumatic and aortic disease.
abstract: BACKGROUND
  The purpose of this study was to determine the differences in aortic morphology that would potentially affect the management of thoracic endovascular aneurysm/aortic repair between trauma and aneurysm patients.
  
  
  METHODS
  This was a prospective analysis of the pretreatment digital imaging of 98 traumatic injury patients and 63 aneurysm patients enrolled in multicenter regulatory studies of the Conformable GORE TAG Thoracic Device (CTAG Device) (manufactured by W.L. Gore and Associates, Flagstaff, AZ). A standardized protocol was used to perform an independent assessment of the images and measurements of the radius of curvature and proximal and distal neck diameters. The radius of curvature was measured using axial images and the proximal and distal intimal neck diameter measurements were completed using the orthogonal "centerline" view. Taper was measured over the entire treated aorta and was calculated by subtracting the distal neck diameter measurement from the proximal neck diameter. The results were analyzed with independent t-tests.
  
  
  RESULTS
  The trauma patients had a significantly smaller radius of curvature than aneurysm patients. There was a significant difference in the aortic neck size, with trauma patients having smaller proximal and distal intimal neck diameters. Taper was noted in trauma patients but not in aneurysm patients.
  
  
  CONCLUSIONS
  The aortic anatomy varies between treated aortic pathologies. Aneurysm patients have a wider arch and larger aortas when compared with trauma patients. Aneurysm patients have less taper than trauma patients. Despite these differences, both of these cohorts of patients are treatable under the broader oversizing ranges of the CTAG Device.
authors.affiliation: Division of Vascular Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin 53792, USA. alberta@surgery.wisc.edu
authors.forename: Hillary B
authors.initials: HB
authors.lastname: Alberta
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Secor
authors.forename: Taylor C
authors.initials: TC
authors.lastname: Smits
authors.forename: Mark A
authors.initials: MA
authors.lastname: Farber
authors.forename: William D
authors.initials: WD
authors.lastname: Jordan
authors.forename: Jon S
authors.initials: JS
authors.lastname: Matsumura
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Aortic arch radius of curvature; Aortic disease; Neck size; Taper; Traumatic disease