The effect of endovascular aortic stents placed across the renal arteries

Malina, Martin; Lindh, Mats; Ivancev, Krassi; Frennby, Bo; Lindblad, Bengt; Brunkwall, Jan

doi:10.1016/s1078-5884(97)80020-2

Cited by 64 publications

(29 citation statements)

References 19 publications

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“…Although clinical and experimental studies have suggested that the impact on the renal ostia or renal blood flow depends mainly on the type of stent-graft used, [25][26][27][28][29][30] gradual accumulation of cellular material on the wire may affect renal blood flow. Liffman et al 24 demonstrated in a recent experimental study that larger deposits on 2 wires across a renal artery model decreased the flow by 41%.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of CT Virtual Intravascular Endoscopy in Aortic Stent-Grafting

Sun¹,

Winder²,

Kelly

et al. 2004

J Endovasc Ther

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VIE was not found to play a role in most preoperative situations compared to axial CT images. However, VIE provided additional postgrafting information on the 3D relationship of the suprarenal stent struts to the aortic branch ostia (in particular the renal and superior mesenteric arteries). VIE findings might aid clinicians in accurately assessing the effect of suprarenal stent-grafting on the renal arteries.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value of CT Virtual Intravascular Endoscopy in Aortic Stent-Grafting

Sun¹,

Winder²,

Kelly

et al. 2004

J Endovasc Ther

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“…Animal experiments with aortic Wallstents crossing the origin of the renal arteries revealed good long-term patency of these high-¯ow branches. Embolic infarctions of the renal parenchyma were not visible [26,27].…”

Section: Application To Clinical Stent Casesmentioning

confidence: 88%

Stent impact on the geometry of the carotid bifurcation and the course of the internal carotid artery

Berkefeld

Jb²,

et al. 2002

Neuroradiology

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A measurement system is proposed to evaluate reconstructive effects of carotid stents on the geometry of the carotid bifurcation and the course of the internal carotid artery. To describe deviations of the stenotic internal carotid artery (ICA) from the extended axis of the common carotid artery (CCA) the CCA-ICA angle is measured between the CCA midaxis and the midaxis of the stenotic ICA segment. Maximal extensions of ICA tortuosities perpendicular to the course of the CCA axis are defined as ICA offset. The measurements were applied to DSA images of 224 carotid stenoses to evaluate variation and correlation between the two parameters. Comparative pre- and post-stent evaluation was performed in two series of 55 and 31 carotid stenoses treated with Wallstents and in a historic control group of 35 stenoses treated with Strecker stents. Straight course of the ICA was associated with low angle and low offset values, whereas tortuous course of the ICA showed larger angle and offset. A moderate linear correlation between the two parameters was found. Corresponding to a straightening of the stented segment, Wallstents reduced mean angle and offset values significantly. In five cases of the second series of Wallstents, transferrals of curves above the distal stent end associated with kinks were observed, and offset remained constant or increased. Strecker stent implantation caused no significant changes of bifurcational geometry. The proposed parameters corresponded to visual aspects of ICA tortuosity and detected reconstructive effects of self-expanding Wallstents on the ICA course. The measurement system may provide a basis for geometric evaluation of different stent types or implantation concepts with the aim: to optimize anatomic recanalization results in tortuous high angle-high offset bifurcations.

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“…Suprarenal stent graft placement, a technical modification from conventional infrarenal stent graft placement, is a technique used for treatment of patients with inappropriate aneurysm necks [3,4]. Unlike open repair, the success of endovascular stent graft placement cannot be ascertained by means of direct examination and thus relies on imaging results.…”

Section: Introductionmentioning

confidence: 99%

Multislice CT angiography in post-aortic stent grafting: optimization of scanning protocols for virtual intravascular endoscopy

Sun

2008

Int J CARS

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Objective The aim of this study is to investigate the optimal 64-slice CT scanning protocols of 3D virtual intravascular endoscopy (VIE) visualization in abdominal aortic aneurysm treated with suprarenal stent grafts, based on an in vitro phantom study. Materials and methodsThe study was performed on a human aorta phantom with a commercially available stent graft in situ. The contrast medium was diluted to produce CT attenuation similar to that used in routine abdominal aortic CT angiography. A series of scans was performed on a 64-slice CT scanner with the scanning protocols being section thickness of 0.5, 1.0, 2.0, 3.0 and 5.0 mm, pitch of 0.9, 1.2 and 1.4 with reconstruction interval of 50% overlap. Quantitative assessment of image quality was performed by measuring the standard deviation (SD) on surfaced rendered VIE images at three anatomic locations, superior mesenteric artery, right renal artery and aortic aneurysm. This aims to determine the degree of stair-step artifacts present on VIE images using a line profile. The thickness of suprarenal stent wires was measured corresponding with each scanning protocol at above same three locations. Subjective assessment of image quality was focused to evaluate the configuration of aortic ostium visualized on VIE images. Results Our results showed that the SD was independent of section thickness and pitch value, although thinner section thickness of 0.5 and 1.0 mm produced better image quality with fewer artifacts. The aortic ostium became irregular or distorted when the section thickness increased to 3.0 and Z. Sun (B) 5.0 mm. Radiation dose was inversely proportional to the pitch values. Conclusion We recommend a scanning protocol of 1.0 mm and pitch 1.4 with reconstruction interval of 0.5 mm as the optimal one of VIE in post-aortic stent grafting as it allows for generation of acceptable images, with fewer artifacts and less radiation dose.

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The effect of endovascular aortic stents placed across the renal arteries

Abstract: Aortic stents placed at the level of the renal arteries do not affect renal blood flow within 1 week in this experimental model. This may prove valuable in endovascular treatment of aortic aneurysms and in other procedures involving stents.

Cited by 64 publications

References 19 publications

Diagnostic Value of CT Virtual Intravascular Endoscopy in Aortic Stent-Grafting

Diagnostic Value of CT Virtual Intravascular Endoscopy in Aortic Stent-Grafting

Stent impact on the geometry of the carotid bifurcation and the course of the internal carotid artery

Multislice CT angiography in post-aortic stent grafting: optimization of scanning protocols for virtual intravascular endoscopy

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