Evidence map›Paper›PMID 38901185›Full record

ArticleComputers in biology and medicine2024

A computational study of artery curvature and endograft oversize influence on seal zone behavior in endovascular aortic repair.

Žiga Donik, Willa Li, Blessing Nnate, Joseph A Pugar, Nhung Nguyen, Ross Milner, Enrique Cerda, Luka Pocivavsek, Janez Kramberger

Abstract read
In one paragraph

Article in Computers in biology and medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Žiga DonikFaculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, 2000 Maribor, Slovenia. Electronic address: ziga.donik@um.si.
Willa LiSection of Vascular Surgery and Endovascular Therapy, Department of Surgery, The University of Chicago, 5841 S Maryland Ave, MC 5028, Chicago, IL 60637, USA.
Blessing NnateSection of Vascular Surgery and Endovascular Therapy, Department of Surgery, The University of Chicago, 5841 S Maryland Ave, MC 5028, Chicago, IL 60637, USA.
Joseph A PugarSection of Vascular Surgery and Endovascular Therapy, Department of Surgery, The University of Chicago, 5841 S Maryland Ave, MC 5028, Chicago, IL 60637, USA.
Nhung NguyenSection of Vascular Surgery and Endovascular Therapy, Department of Surgery, The University of Chicago, 5841 S Maryland Ave, MC 5028, Chicago, IL 60637, USA.
Ross MilnerSection of Vascular Surgery and Endovascular Therapy, Department of Surgery, The University of Chicago, 5841 S Maryland Ave, MC 5028, Chicago, IL 60637, USA.
Enrique CerdaDepartamento de Física, Facultad de Ciencia, Universidad de Santiago de Chile (USACH), Santiago Chile.
Luka PocivavsekSection of Vascular Surgery and Endovascular Therapy, Department of Surgery, The University of Chicago, 5841 S Maryland Ave, MC 5028, Chicago, IL 60637, USA. Electronic address: lpocivavsek@bsd.uchicago.edu.
Janez KrambergerFaculty of Mechanical Engineering, University of Maribor, Smetanova ulica 17, 2000 Maribor, Slovenia.

Funding

A Geometric and Morphoelastic Study of Aortic Dissection EvolutionR01HL159205 · NHLBI · UNIVERSITY OF CHICAGO · PI POCIVAVSEK, LUKA · 2021 to 2025
$2.5M
NHLBI NIH HHS R01 HL159205
6 · The paper itself

Abstract

Thoracic endovascular aortic repair (TEVAR) is a minimally invasive procedure involving the placement of an endograft inside the dissection or an aneurysm to direct blood flow and prevent rupture. A significant challenge in endovascular surgery is the geometrical mismatch between the endograft and the artery, which can lead to endoleak formation, a condition where blood leaks between the endograft and the vessel wall. This study uses computational modeling to investigate the effects of artery curvature and endograft oversizing, the selection of an endograft with a larger diameter than the artery, on endoleak creation. Finite element analysis is employed to simulate the deployment of endografts in arteries with varying curvature and diameter. Numerical simulations are conducted to assess the seal zone and to quantify the potential endoleak volume as a function of curvature and oversizing. A theoretical framework is developed to explain the mechanisms of endoleak formation along with proof-of-concept experiments. Two main mechanisms of endoleak creation are identified: local buckling due to diameter mismatch and global buckling due to centerline curvature mismatch. Local buckling, characterized by excess graft material buckling and wrinkle formation, increases with higher levels of oversizing, leading to a larger potential endoleak volume. Global buckling, where the endograft bends or deforms to conform to the centerline curvature of the artery, is observed to require a certain degree of oversizing to bridge the curvature mismatch. This study highlights the importance of considering both curvature and diameter mismatch in the design and clinical use of endografts. Understanding the mechanisms of endoleak formation can provide valuable insights for optimizing endograft design and surgical planning, leading to improved clinical outcomes in endovascular aortic procedures.

Indexed as

Endovascular ProceduresModels, CardiovascularAorta, ThoracicBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationComputer SimulationEndoleakEndovascular Aneurysm RepairFinite Element AnalysisHumansEndoleakEndovascular aortic repairEVARFinite element analysis (FEA)Stent graftTEVAR

Identifiers

PMID38901185
PMCPMC11317088

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.