Hector W L de Beaufort1, Michele Conti2, Arnoud V Kamman1, Foeke J H Nauta1, Ettore Lanzarone3, Frans L Moll4, Joost A van Herwaarden4, Ferdinando Auricchio2, Santi Trimarchi5. 1. Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Milan, Italy. 2. Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy. 3. Institute of Applied Mathematics and Information Technologies (IMATI), National Research Council of Italy (CNR), Milan, Italy. 4. Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 5. Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Milan, Italy. Electronic address: santi.trimarchi@grupposandonato.it.
Abstract
BACKGROUND: Aortic stiffness is an independent predictor of cardiovascular mortality. In this study, the effect of thoracic endovascular aortic repair (TEVAR) on aortic stiffness is investigated by measuring aortic pulse wave velocity (PWV) in an ex vivo porcine model. METHODS: Fifteen fresh porcine thoracic aortas were connected to a benchtop pulsatile system. Intraluminal pressures were recorded in the ascending aorta and at the celiac trunk using a needle connected to a pressure sensor. The distance between the needles was divided by the time difference between the base of the pressure peaks to calculate aortic PWV at baseline and after stent-graft deployment and distal stent-graft extension. RESULTS: Mean aortic PWV was 5.0 m/s at baseline. PWV increased by 4% after proximal stent-graft deployment (P = 0.09) and by 18% after stent-graft extension (P < 0.001). Pulse pressure in the nonstented ascending aorta increased by 11.0 ± 1.2 mm Hg after proximal stent-graft deployment (P < 0.001) and by 17.3 ± 1.5 mm Hg after stent-graft extension (P < 0.001). The increases in PWV and pulse pressure showed a positive linear correlation with the percentage of stent-graft coverage (P < 0.001 and P < 0.001). CONCLUSIONS: In this experimental setup, aortic stiffness increased after stent-graft deployment, dependent on the percentage of the aorta that was covered by stent graft. These results show that TEVAR leads to significant changes in aortic hemodynamics, which merits evaluation in the clinical setting.
BACKGROUND: Aortic stiffness is an independent predictor of cardiovascular mortality. In this study, the effect of thoracic endovascular aortic repair (TEVAR) on aortic stiffness is investigated by measuring aortic pulse wave velocity (PWV) in an ex vivo porcine model. METHODS: Fifteen fresh porcine thoracic aortas were connected to a benchtop pulsatile system. Intraluminal pressures were recorded in the ascending aorta and at the celiac trunk using a needle connected to a pressure sensor. The distance between the needles was divided by the time difference between the base of the pressure peaks to calculate aortic PWV at baseline and after stent-graft deployment and distal stent-graft extension. RESULTS: Mean aortic PWV was 5.0 m/s at baseline. PWV increased by 4% after proximal stent-graft deployment (P = 0.09) and by 18% after stent-graft extension (P < 0.001). Pulse pressure in the nonstented ascending aorta increased by 11.0 ± 1.2 mm Hg after proximal stent-graft deployment (P < 0.001) and by 17.3 ± 1.5 mm Hg after stent-graft extension (P < 0.001). The increases in PWV and pulse pressure showed a positive linear correlation with the percentage of stent-graft coverage (P < 0.001 and P < 0.001). CONCLUSIONS: In this experimental setup, aortic stiffness increased after stent-graft deployment, dependent on the percentage of the aorta that was covered by stent graft. These results show that TEVAR leads to significant changes in aortic hemodynamics, which merits evaluation in the clinical setting.
Authors: Hector W L de Beaufort; Margherita Coda; Michele Conti; Theodorus M J van Bakel; Foeke J H Nauta; Ettore Lanzarone; Frans L Moll; Joost A van Herwaarden; Ferdinando Auricchio; Santi Trimarchi Journal: PLoS One Date: 2017-10-05 Impact factor: 3.240