Patient demographics and cardiovascular risk factors differentially influence geometric remodeling of the aorta compared with the peripheral arteries

Abstract

Background Detailed knowledge of the dimensions and shape of the main arteries of the body and how they change with age and disease is important for understanding arterial pathophysiology and improving minimally invasive devices to treat arterial diseases. Our goal was to describe and compare geometric remodeling of the aorta and peripheral arteries in the context of patient demographics and cardiovascular risk factors. Methods 3D reconstructions of Computerized Tomography Angiography scans were performed in n=122 subjects 5-93 years old (mean 47±24 years, 64M/58F). Best-fit arterial diameters, lengths and tortuosity for the principle named arteries in the chest, abdomen, pelvis and upper thigh were measured, and multiple linear regression analysis was performed to examine how these morphological parameters associate with patient demographics and risk factors. Results Large elastic arteries increased their diameter, length and tortuosity with age, while muscular arteries primarily became more tortuous. Demographics and risk factors explained >70% of the variation in diameters of the abdominal aorta, paravisceral aorta, and the aortic arch; and >75% of variation in tortuosity from the profunda femoris to the brachiocephalic artery. Male gender, larger body mass index and hypertension contributed to larger diameters, while presence of diabetes was associated with somewhat straighter arteries. Overall the effects of cardiovascular risk factors on geometric remodeling were small compared to those of demographics. Conclusions The geometry of the vascular tree is significantly affected by aging, demographics and some risk factors. Elastic and muscular arteries remodel differently, possibly due to differences in their microstructure.

Limb flexion-induced twist and associated intramural stresses in the human femoropopliteal artery

“…These improvements over the original method [14] . These values are significantly larger than those summarized by Ansari et al [9] (2-48 cm 21 ), but more conservative than the 778 cm 21 average PA twist reported by MacTaggart et al [14]. The discrepancy with the latter can be attributed to a larger sample size, better experimental technique, more uniform marker placement, and a different normalization scheme used in the current study.…”

“…They used two arterial side branches as markers to track SFA deformations as the limb was flexed from the supine to the fetal positions producing 2. 21 . This study was performed to refine these values in a larger sample size (n ¼ 28 limbs) using an expanded, refined and validated methodology with improved marker design, vessel perfusion and stress analysis.…”

“…Three-dimensional volumetric reconstructions of the leg, artery and markers were performed with Mimics software using a variety of segmentation and region growing techniques [14,21]. Arterial volumes were created and used to construct luminal rsif.royalsocietypublishing.org J. R. Soc.…”

“…However, in this study we are focusing on the effects of torsion and therefore assume l z ¼ 1. The physical components of the deformation gradient F in cylindrical coordinates are After enforcing incompressibility (def F ¼ 1), we obtain l r ¼ (l u l z ) 21 as well as the relation between unloaded and loaded radii:…”

Computer-assisted study of the axial orientation and distances between renovisceral arteries ostia

“…Endovascular techniques are based on fluoroscopy-guided intra-arterial navigation. Catheterization of renal and digestive arteries is mandatory in numerous procedures such as the treatment of renovisceral arteries stenosis or aneurysms [22], para-renal and thoraco-abdominal aneurysms repair [11] and selective embolization.…”