Evidence map›Paper›PMID 40126785›Full record

ArticleCardiovascular engineering and technology2025

Optimizing the Radiopacity of an Injectable Polymer on Fluoroscopy used for Treatment of Type II Endoleak After Endovascular Aneurysm Repair.

Jeffrey R Nagel, Erik Groot Jebbink, Stefan P M Smorenburg, Arjan W J Hoksbergen, Rutger J Lely, Michel Versluis, Michel M P J Reijnen

Abstract read
In one paragraph

Article in Cardiovascular engineering and technology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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

7 authors.

Jeffrey R NagelMulti-Modality Medical Imaging group, University of Twente, Enschede, The Netherlands.ORCID 0000-0002-4816-9214
Erik Groot JebbinkMulti-Modality Medical Imaging group, University of Twente, Enschede, The Netherlands. e.grootjebbink@utwente.nl.ORCID 0000-0001-7041-8603
Stefan P M SmorenburgDepartment of Surgery, Amsterdam UMC location Vrije Universiteit, Amsterdam, The Netherlands.ORCID 0000-0002-4754-3016
Arjan W J HoksbergenDepartment of Surgery, Amsterdam UMC location Vrije Universiteit, Amsterdam, The Netherlands.ORCID 0000-0002-3140-5225
Rutger J LelyDepartment of Radiology, Amsterdam UMC location Vrije Universiteit, Amsterdam, The Netherlands.ORCID 0000-0003-1741-9126
Michel VersluisPhysics of Fluids group, University of Twente, Enschede, The Netherlands.ORCID 0000-0002-2296-1860
Michel M P J ReijnenMulti-Modality Medical Imaging group, University of Twente, Enschede, The Netherlands.ORCID 0000-0002-5021-1768

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeType II endoleaks (T2EL) are a common complication after endovascular aneurysm repair. AneuFix is a newly designed elastic polymer for T2EL. AneuFix contains tantalum for visualization during fluoroscopy, which is crucial for monitoring the polymer in the side branches. The purpose of this study was to find the lowest concentration tantalum that is sufficient for safe injection in the aneurysmal sac.

methodsAneuFix polymer with tantalum concentrations between 0 and 30% was injected into endoleak phantoms, connected to a pulsatile flow setup and with a realistic background for fluoroscopy. Furthermore, the radiopacity was investigated on fluoroscopic systems from three different vendors, using static phantoms. Results from both the dynamic and static phantoms were qualitatively evaluated by 10 clinical experts.

resultsConcentrations of ≥ 20% tantalum were consistently detected within the first 5 mm after entering the side branch, with a corresponding contrast-to-noise ratio of 2.23 ± 0.21. Furthermore, sufficient detectability scores (of at least 3 out of 5) were given to ≥ 15% tantalum. Significant differences were found in detectability scores on different fluoroscopic systems, using the default lowest-radiation-dose scan protocol for each system.

conclusionsThis study showed that tantalum concentrations ≥ 20% are consistently detected on fluoroscopy in the specified region. Compared to the original 30%, this would reduce imaging artifacts from high attenuation and scattering on follow-up imaging, while retaining sufficient detectability during injection. However, because of differences in fluoroscopic systems and scan protocols between hospitals, the combination of tantalum concentration and scan protocol should be optimized for each clinical setting.

Indexed as

Aortic Aneurysm, AbdominalAortographyBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationContrast MediaEndoleakEndovascular ProceduresPolymersRadiography, InterventionalTantalumEndovascular Aneurysm RepairFluoroscopyHumansPhantoms, ImagingPredictive Value of TestsRadiation DosageContrast MediaPolymersTantalumAbdominal aortic aneurysmEndoleakInjectable embolic agentRadiopacityTantalum

Identifiers

PMID40126785
PMCPMC12367875

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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.