Marco Midulla MD, PhD, Presenter: Nothing to Disclose

Ramiro Moreno MS, Abstract Co-Author: Nothing to Disclose

Stephan Haulon, Abstract Co-Author: Nothing to Disclose

Franc Nicoud, Abstract Co-Author: Nothing to Disclose

Christophe Demattei, Abstract Co-Author: Nothing to Disclose

Jean-Paul Beregi MD, Abstract Co-Author: Nothing to Disclose

Anne Negre-Salvayre, Abstract Co-Author: Nothing to Disclose

Jean-Pierre Pruvo MD, PhD, Abstract Co-Author: Nothing to Disclose

Herve Pierre Rousseau MD, Abstract Co-Author: Nothing to Disclose

Endovascular repair has dramatically changed the physicians approach to the thoracic aortic pathology. Although the advancements in clinical experience, little is known about the impact of the implantation on the native aortic functional status. The aim of this study is to evaluate the haemodynamic modifications before and after the endografting by proposing a comparative analysis of the quantitative assessments by a CT-based Computational Fluid Dynamics Imaging.

40 patient-specific aortic geometries were obtained from an image dataset of pre and postoperative angio CT acquisitions in 20 consecutive patients treated by thoracic endografting for different aortic pathologies (11 TAA, 5 False Aneurysms, 3 Penetrating Ulcers, 1 ATAR). After image processing, a commercially available software system (XFlow, Next Limit Technologies) using a particle-based meshless approach was adopted to obtain the numerical simulations of the flow behaviour. WSS (Pa) and vorticity (Hz) values were measured at the proximal and distal landing zones and the median pre-postoperative ratios were registered.

Haemodynamic simulations were obtained for all the patients and quantitative analyses were accomplished (technical success 100%). Median WSS ratios respectively at the proximal and distal landing zone were: 0.96 (median values 4.19, 4.90 Pa) and 0.83 (median values 1.66, 2.06). Concerning the vorticity, median ratios were respectively 1.01 (proximal zone; median values 40.38, 39.17 Hz) and 0.80 (distal zone; median values 15.16, 17.22). Statistical analysis showed a difference in WSS (P=0.02) and vorticity (P=0.03) at the proximal landing zone depending on the specific anatomical implantation site (Z2-Z4).

A CT-based CFD approach is a promising imaging tool to obtain haemodynamic simulations of the thoracic aortic environment. The approach adopted in this experience allowed to accomplish a preliminary quantitative analysis comparing the pre and postoperative functional status which encourages next larger studies to gain better understanding of the impact of the endovascular treatment on the native vessel.

To provide an imaging tool for the investigation of the thoracic aorta haemodynamics in order to weigh up the functional impact of endografting on the native vessel.

Midulla, M, Moreno, R, Haulon, S, Nicoud, F, Demattei, C, Beregi, J, Negre-Salvayre, A, Pruvo, J, Rousseau, H, Impact of Thoracic Endografting on the Native Aortic Haemodynamics: Quantitative Comparative Analysis of the Functional Assessments by CT-computational Fluid Dynamics (CFD) Imaging before and after the Device Implantation.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012853.html