TY - JOUR
T1 - Stent-Graft Deployment Increases Aortic Stiffness in an Ex Vivo Porcine Model
AU - de Beaufort, Hector W.L.
AU - Conti, Michele
AU - Kamman, Arnoud V.
AU - Nauta, Foeke J.H.
AU - Lanzarone, Ettore
AU - Moll, Frans L.
AU - van Herwaarden, Joost A.
AU - Auricchio, Ferdinando
AU - Trimarchi, Santi
N1 - Funding Information:
This work is partially funded by: ERC Starting Grant through the Project ISOBIO: Isogeometric Methods for Biomechanics [No. 259229]; Ministero dell'Istruzione,dell'Università e della Ricerca [Project no. 2010BFXRHS], iCardioCloud project by Cariplo Foundation [no. 2013-1779] and Lombardy Region [No. 42938382; No. 46554874].
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background Aortic stiffness is an independent predictor of cardiovascular mortality. In this study, the effect of thoracic endovascular aortic repair (TEVAR) on aortic stiffness is investigated by measuring aortic pulse wave velocity (PWV) in an ex vivo porcine model. Methods Fifteen fresh porcine thoracic aortas were connected to a benchtop pulsatile system. Intraluminal pressures were recorded in the ascending aorta and at the celiac trunk using a needle connected to a pressure sensor. The distance between the needles was divided by the time difference between the base of the pressure peaks to calculate aortic PWV at baseline and after stent-graft deployment and distal stent-graft extension. Results Mean aortic PWV was 5.0 m/s at baseline. PWV increased by 4% after proximal stent-graft deployment (P = 0.09) and by 18% after stent-graft extension (P < 0.001). Pulse pressure in the nonstented ascending aorta increased by 11.0 ± 1.2 mm Hg after proximal stent-graft deployment (P < 0.001) and by 17.3 ± 1.5 mm Hg after stent-graft extension (P < 0.001). The increases in PWV and pulse pressure showed a positive linear correlation with the percentage of stent-graft coverage (P < 0.001 and P < 0.001). Conclusions In this experimental setup, aortic stiffness increased after stent-graft deployment, dependent on the percentage of the aorta that was covered by stent graft. These results show that TEVAR leads to significant changes in aortic hemodynamics, which merits evaluation in the clinical setting.
AB - Background Aortic stiffness is an independent predictor of cardiovascular mortality. In this study, the effect of thoracic endovascular aortic repair (TEVAR) on aortic stiffness is investigated by measuring aortic pulse wave velocity (PWV) in an ex vivo porcine model. Methods Fifteen fresh porcine thoracic aortas were connected to a benchtop pulsatile system. Intraluminal pressures were recorded in the ascending aorta and at the celiac trunk using a needle connected to a pressure sensor. The distance between the needles was divided by the time difference between the base of the pressure peaks to calculate aortic PWV at baseline and after stent-graft deployment and distal stent-graft extension. Results Mean aortic PWV was 5.0 m/s at baseline. PWV increased by 4% after proximal stent-graft deployment (P = 0.09) and by 18% after stent-graft extension (P < 0.001). Pulse pressure in the nonstented ascending aorta increased by 11.0 ± 1.2 mm Hg after proximal stent-graft deployment (P < 0.001) and by 17.3 ± 1.5 mm Hg after stent-graft extension (P < 0.001). The increases in PWV and pulse pressure showed a positive linear correlation with the percentage of stent-graft coverage (P < 0.001 and P < 0.001). Conclusions In this experimental setup, aortic stiffness increased after stent-graft deployment, dependent on the percentage of the aorta that was covered by stent graft. These results show that TEVAR leads to significant changes in aortic hemodynamics, which merits evaluation in the clinical setting.
UR - http://www.scopus.com/inward/record.url?scp=85020076313&partnerID=8YFLogxK
U2 - 10.1016/j.avsg.2017.04.024
DO - 10.1016/j.avsg.2017.04.024
M3 - Article
C2 - 28483612
AN - SCOPUS:85020076313
SN - 0890-5096
VL - 43
SP - 302
EP - 308
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
ER -