Details

Autor(en) / Beteiligte

• Suh, Ga-Young, PhD
• Choi, Gilwoo, PhD
• Herfkens, Robert J., MD
• Dalman, Ronald L., MD
• Cheng, Christopher P., PhD

Titel

Three-Dimensional Modeling Analysis of Visceral Arteries and Kidneys during Respiration

Ist Teil von

• Annals of vascular surgery, 2016-07, Vol.34, p.250-260

Ort / Verlag

Netherlands: Elsevier Inc

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Background Visceral arteries are commonly involved in endovascular repair of complex abdominal aortic aneurysms. To improve repair techniques and reduce long-term complications involving visceral arteries, it is crucial to understand in vivo arterial geometry and the deformations due to visceral organ movement with respiration. This study quantifies deformation of the celiac, superior mesenteric, and renal arteries during respiration, and correlates the deformations with diaphragmatic excursion. Methods 16 patients with small abdominal aortic aneurysms underwent magnetic resonance angiography during inspiratory and expiratory breathholds. From geometric models of the aorta and visceral arteries, vessel length, branch angle, curvature, and positions were computed, along with degree of diaphragmatic excursion as indicated by kidney translation. Results From inspiration to expiration, the celiac artery exhibited axial shortening of 4.8 ± 6.4 % (P< 0.001) and a mean curvature increase of 0.03 ± 0.02 mm-1 , greater than other visceral arteries (P< 0.01). With expiration, the superior mesenteric, left and right renal arteries angled upward by -9.8 ± 6.4°, -6.4 ± 6.4°, and -5.2 ± 5.0°, respectively (P< 0.005). All vessels translated superiorly (P< 0.0005) and posteriorly (P< 0.01), and the superior mesenteric artery additionally translated rightward (P< 0.005). The left and right kidneys translated by 22 ± 9 mm and 21 ± 9 mm, mostly superiorly (P< 0.001). Translations of all visceral arteries were moderately correlated to the right kidney (R> 0.50). Correlation of the left renal artery with the left kidney was greater than that of the right renal artery with the right kidney. Conclusions The celiac artery exhibited lower branch angle change, and greater axial and curvature deformations than the other visceral arteries, due to the vicinity to the liver and influence of the median arcuate ligament. Correlation between visceral arteries and kidney translations revealed that diaphragmatic excursion affects vessel mobility. Weaker correlation of the right renal artery to the right kidney indicates mechanical shielding from the inferior vena cava.