Quantitative assessment of the conformational change in the femoropopliteal artery with leg movement

Klein, Andrew J.; Chen, S. James; Messenger, John C.; Hansgen, Adam; Plomondon, Mary E.; Carroll, John D.; Casserly, Ivan P.

doi:10.1002/ccd.22124

Cited by 125 publications

(115 citation statements)

References 17 publications

(21 reference statements)

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“…13,14 The comparison of our results with the previous studies suggest that, although there are significant deformations in the PAs of diseased patients during leg flexion, the amount of change observed in the PAD patients does not differ significantly from the ones observed in healthy volunteers. 14,17,18 The differences between the published results are likely to be attributed to anatomical variations between patients.…”

Section: Discussionsupporting

confidence: 70%

“…2,6 Excessive biomechanical deformations may constitute possible explanations for the limited success of stents in these arterial segments. [12][13][14] To provide a deeper understanding about the mechanical environment in popliteal arteries during flexion, arterial deformations of five patients with various levels of arterial calcifications ranging from mild to severe were quantified based on 3D rotational CT imaging.…”

Section: Discussionmentioning

confidence: 99%

“…Another limitation concerns the limited number of patients included; however, the typical number of subjects in similar work is between 1 and a maximum of 10. [12][13][14]17,18 In addition, the patients considered in this study covered a large range of arterial calcifications, which is sufficient to provide an assessment of the effect of the PAD on the arterial deformations.…”

Section: Discussionmentioning

confidence: 99%

“…4,11 Stent failures are clearly associated with the forces exerted on the FPAS, which are caused by bending, torsion and axial motions during hip and knee flexion. [12][13][14] Moreover, the effects of this mechanical environment, along with different stent designs and material properties, on the stent-artery wall interactions lead to arterial wall damage.…”

Section: Introductionmentioning

confidence: 99%

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Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study

Gökgöl

Diehm

Kara

et al. 2013

Journal of Endovascular Therapy

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Purpose: To quantify the in-vivo deformations of the popliteal arterial segment (PAS) during leg flexion in subjects with clinically relevant (Fontaine Stage IIb) peripheral arterial disease (PAD).Methods: Five patients with varying calcification levels of the PAS undergoing endovascular revascularization underwent 3D rotational angiography. Image acquisition was performed with the leg straight and with a flexion of 70°/20° in the knee/hip joint. The arterial centerline and the corresponding branches in both positions were segmented to create 3D reconstructions of the arterial trees. Axial deformation, twisting, and curvatures were quantified. Furthermore, the relationships between the calcification levels and the deformations were investigated. Results:We observed an average shortening of the PAS of 5.9% ± 2.5% and twist rate of 3.8 Conclusions:The PAS of patients with symptomatic PAD is exposed to significant deformations during flexion of the knee joint. The curvature is directly affected by the extent of arterial calcification. In contrast, the changes in arterial length and twisting angles are comparable to those of healthy arteries. These measurements have the potential to be used for realistic arterial modeling to improve stent designs.This study also showed the ability of rotational angiography to quantify the three-dimensional deformations of the PAS in patients with various levels of calcification, and that this technique can be used to collect data on larger groups of patients.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study

Gökgöl

Diehm

Kara

et al. 2013

Journal of Endovascular Therapy

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“…Table III summarizes several important outcome studies. Earlier stent designs were plagued by stent fractures related to complex biophysical forces in this arterial segment, and associated target vessel failure [14,15]. It is currently not clear whether all stent systems are equivalent in terms of design, engineering, and long-term performance.…”

Section: Self-expanding Stentsmentioning

confidence: 99%

SCAI expert consensus statement for femoral‐popliteal arterial intervention appropriate use

Klein

Pinto

Gray

et al. 2014

Cathet Cardio Intervent

Self Cite

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Successful endovascular intervention for femoral-popliteal (FP) arterial disease provides relief of claudication and offers limb-salvage in cases of critical limb ischemia. Technologies and operator technique have evolved to the point where we may now provide effective endovascular therapy for a spectrum of lesions, patients, and clinical scenarios. Endovascular treatment of this segment offers a significant alternative to surgical revascularization, and may confer improved safety for a wide range of patients, not solely those deemed high surgical risk. Although endovascular therapy of the FP segment has historically been hampered by high rates of restenosis, emerging technologies including drug-eluting stents, drug-coated balloons, and perhaps bioabsorbable stent platforms, provide future hope for more durable patency in complex disease. By combining lessons learned from clinical trials, international trends in clinical practice, and insights regarding emerging technologies, we may appropriately tailor our application of endovascular therapy to provide optimal care to our patients. This document was developed to guide physicians in the clinical decision-making related to the contemporary application of endovascular intervention among patients with FP arterial disease. V C 2014 Wiley Periodicals, Inc.

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Endovascular Treatment of Popliteal Artery Aneurysms: The Role of Stent‐Grafts and Thrombolysis

Farber

Tan

2012

Haimovici's Vascular Surgery

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Quantitative assessment of the conformational change in the femoropopliteal artery with leg movement

Cited by 125 publications

References 17 publications

Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study

Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study

SCAI expert consensus statement for femoral‐popliteal arterial intervention appropriate use

Endovascular Treatment of Popliteal Artery Aneurysms: The Role of Stent‐Grafts and Thrombolysis

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