Morphological Analysis of Healthy Aortic Arch

Boufi, Mourad; Guivier-Curien, Carine; Loundou, Anderson; Deplano, Valérie; Boiron, Olivier; Chaumoître, Kathia; Gariboldi, Vlad; Alimi, Yves

doi:10.1016/j.ejvs.2017.02.023

Cited by 45 publications

(22 citation statements)

References 20 publications

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“…Imaging analyses for the parameters of the aortic arch and carotid artery were similar to those described in the literature. 9,11 Carotid and aortic length and angulation were directly calculated in the sagittal and coronal planes. Carotid and aortic length were defined as the curvilinear distance between the vessel origin and end.…”

Section: Anatomic Measurement Protocolmentioning

confidence: 99%

Impact of Aortic Arch Anatomy on Technical Performance and Clinical Outcomes in Patients with Acute Ischemic Stroke

Knox¹,

Alexander

McCoy³

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Arterial access is a technical consideration of mechanical thrombectomy that may affect procedural time, but few studies exist detailing the relationship of anatomy to procedural times and patient outcomes. We sought to investigate the respective impact of aortic arch and carotid artery anatomy on endovascular procedural times in patients with large-vessel occlusion. MATERIALS AND METHODS: We retrospectively reviewed imaging and medical records of 207 patients from 2 academic institutions who underwent mechanical thrombectomy for anterior circulation large-vessel occlusion from January 2015 to July 2018. Preintervention CTAs were assessed to measure features of the aortic arch and ipsilateral great vessel anatomy. These included the cranial-to-caudal distance from the origin of the innominate artery to the top of the aortic arch and the takeoff angle of the respective great vessel from the arch. mRS scores were calculated from rehabilitation and other outpatient documentation. We performed bootstrap, stepwise regressions to model groin puncture to reperfusion time and binary mRS outcomes (good outcome, mRS # 2). RESULTS: From our linear regression for groin puncture to reperfusion time, we found a significant association of the great vessel takeoff angle (P 4 .002) and caudal distance from the origin of the innominate artery to the top of the aortic arch (P 4 .05). Regression analysis for the binary mRS revealed a significant association with groin puncture to reperfusion time (P , .001). CONCLUSIONS: These results demonstrate that patients with larger takeoff angles and extreme aortic arches have an association with longer procedural times as approached from transfemoral access routes. ABBREVIATIONS: CCA 4 common carotid artery; CCIA 4 the cranial-to-caudal distance from the origin of the innominate artery to the top of the aortic arch; GPRT 4 groin puncture to reperfusion time; HTN 4 hypertension; LVO 4 large-vessel occlusion I schemic stroke is the fifth leading cause of death and the leading cause of long-term disability in the United States. 1 Recent studies have established mechanical thrombectomy as the criterion standard of care for large-vessel occlusion over tPA alone. 2-5 These and other studies have demonstrated that reduced time between the onset of symptoms and reperfusion leads to better clinical outcomes. 6,7 That time interval comprises prehospital

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Section: Anatomic Measurement Protocolmentioning

confidence: 99%

Impact of Aortic Arch Anatomy on Technical Performance and Clinical Outcomes in Patients with Acute Ischemic Stroke

Knox¹,

Alexander

McCoy³

et al. 2020

AJNR Am J Neuroradiol

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“…Aortic morphology has been reported to be associated with age. A study of 123 subjects without thoracic aorta pathology or surgery found that the aortic diameter enlarges, the posterior arch elongates, the tortuosity index decreases, and the attachment zone angle is larger in older people [1]. Age had a correlation coefficient of 0.61 with arch length (p < 0.01) in the study.…”

Section: Introductionmentioning

confidence: 63%

“…The percentage of patients showing elongation at the STJ-INA segment during the follow-up was 2%, 5%, 12%, 15%, and 20% at the first, second, third, fourth, and fifth year follow-up (Table 4). 1 The data are presented as the number of patients showing lengthening of the aortic segment of 10 mm or more, which was classified as having elongation. STJ: sinotubular junction; INA: innominate artery; LCCA: left common carotid artery; LSCA: left subclavian artery; CA: celiac artery.…”

Section: Elongationmentioning

confidence: 99%

Elongation of the Aorta after Thoracic Endovascular Aortic Repair: A longitudinal study

Chen

Chou

Chang

et al. 2020

IJERPH

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Aortic morphology is associated with age, with the diameter being larger in older people. Thoracic endovascular aortic repair (TEVAR) is a treatment for aortic diseases, such as aortic dissection. When evaluating patients, aortic elongation could interfere with the classification of TEVAR complications. The longitudinal change in aortic length has not been studied in detail. In patients receiving thoracic endovascular aortic repair between 2007 and 2013, we determined the aortic length between the sinotubular junction, left common carotid artery, subclavian artery, and celiac artery on their first five annual follow-up computed tomography (CT) exams. Using the immediate post-TEVAR follow-up CT as the comparison reference and a lengthening of the aortic segment by 10 mm or more as the definition of elongation, 16 of 41 (39%) showed elongation between the innominate artery and celiac artery. When compared with the immediate follow-up CT, a higher proportion of patients showed elongation at the fifth year’s follow-up CT than the first year’s follow-up CT (p < 0.01), and the average lengthening per year was 1.7 mm. There was progressive lengthening of the aorta after TEVAR.

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“…Third, the human arch anatomy has significant morphological differences. 20 The unibody branched stent grafts have to be custom-made for apparent anatomical variability. Finally, the introducer sheath applied to human patients could be 22e24F and so the diameter of the stent graft system should be further decreased in future studies.…”

Section: Discussionmentioning

confidence: 99%

A Feasibility Study of a New Unibody Branched Stent Graft Applied to Reconstruct the Canine Aortic Arch

Zhai

et al. 2018

European Journal of Vascular and Endovascular Surgery

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Morphological Analysis of Healthy Aortic Arch

Cited by 45 publications

References 20 publications

Impact of Aortic Arch Anatomy on Technical Performance and Clinical Outcomes in Patients with Acute Ischemic Stroke

Impact of Aortic Arch Anatomy on Technical Performance and Clinical Outcomes in Patients with Acute Ischemic Stroke

Elongation of the Aorta after Thoracic Endovascular Aortic Repair: A longitudinal study

A Feasibility Study of a New Unibody Branched Stent Graft Applied to Reconstruct the Canine Aortic Arch

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