Cine MRI Assessment of Aortic Aneurysm Dynamics Before and After Endovascular Repair

Abstract

After EVAR, increased longitudinal translation of both the aneurysm and stent-graft was observed, indicating downward pulling forces at the proximal fixation site. Secondly, increased bending was seen at the site of maximal angulation, which implies a risk of metal fatigue and fabric damage at sites of stent-graft angulation.

Fluoroscopic Roentgen stereophotogrammetric analysis (FRSA) to study three-dimensional stent graft dynamics

“…Moreover, rotational motion cannot be quantified at all. In addition, the spatial resolution of these techniques is limited 6 and their accuracy and reproducibility have not been validated. Because FRSA uses direct 3D reconstruction of the images, the listed limitations do not apply to this technique.…”

“…Dilatation, axial, transverse, and rotational motion of the aorta occur during the cardiac cycle. [4][5][6][7][8] Detailed knowledge of stent graft dynamics after EVAR is indispensable to continue improving stent graft design and (preclinical) testing.…”

“…[4][5][6] The most important disadvantage of these modalities is that reconstructions are limited to a single, twodimensional (2D) plane, making 3-D motion analysis impossible. 9 Recently, an experimental study demonstrated that fluoroscopic Roentgen stereophotogrammetric analysis (FRSA) is able to accurately and precisely quantify real time 3D dynamics of stent grafts during the cardiac cycle with a mean measurement error of 0.003 Ϯ 0.019 mm.…”

Development of fibrinous thrombus analogue for in-vitro abdominal aortic aneurysm studies

“…Cine MRI after EVAR demonstrated increased pulsatile cranial-caudal translation of the aneurysm during the heart cycle. Anteroposterior translation of the aneurysm and pulsatile wall motion of the stentgraft were beneath the detection of cine MRI (o0.5 mm) (Vos et al, 2003).…”

“…The pulsatile wall motion of aneurysms of 6 cm is less than 0.5 mm after EVAR (Lindblad et al, 2004;Vos et al, 2003). Hence, the deformation of the thrombus remains small so we expect that its material behavior can be assumed linear.…”